The finite element model may be utilized for the comparison of different methods of osteosynthesis for the treatment of injuries described above. Due to several difficulties in investigations performed on cadaver specimens, this model has undoubted utility.
Based on our results, we recommend osteosynthesis in the case of Garden type III femoral neck fractures and, in turn, arthroplasty with respect to the high rate of early redisplacement in the case of Garden type IV fractures, especially in the case of subcapital fractures. For patients confined to a bed and in poor general condition (ASA score IV), the first choice treatment option is the minimally invasive percutaneous osteosynthesis.
Bevezetés: A súlyos kimenetelű csípőtáji törések leggyakrabban az egyre nagyobb részarányt képviselő időskorú lakos ság körében fordulnak elő. Célkitűzés: A EuroHOPE kutatás reguláris adatgyűjtésekre támaszkodva 7 országban vizsgálta a csípőtáji törések legfontosabb ellátási jellemzőit és eredményeit.
Analysis of hip fracture care in Hungary between 2004-2009Introduction: Proximal femoral fractures with severe outcome are most common in the increasing group of elderly patients. Aim: Based on the regular data gathered by the EuroHOPE research, the most important aspects and re sults of the treatment of proximal femoral fractures were studied. Method: Data of hospital admissions due to proxi mal femoral fractures were analyzed. Results: There was a slight increase in the number of hospitalized patients bet ween 2004 and 2009 in Hungary. 88% of the patients received operative treatment, 41% suffered femoral neck fractures. Mortality rates did not change significantly in the analyzed period. Standardized annual mortality rates for patients who had suffered a femoral neck fracture were 28% when prosthesis was implanted; this result was somewhat more favorable than in case of other surgical procedures. Annual mortality rates were higher in the peritrochanteric fracture group where intramedullary nailing was performed (36%). The ratio of operated patients did not differ sig nificantly from international results. Mortality rates in Hungary were significantly less favorable. 30 day standardized mortality rate was 13.6% in 2008, twice as high as the rate in Finland, The Netherlands, Norway, Scotland and Swe den. The 40% mortality rate calculated for 365 days was significantly higher than international results. Conclusion: To define the measures needed to improve results, systematic analysis of both inhospital treatment protocols, and fol lowup treatment is necessary.
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