Expansion of vein thrombosis and embolism remains a serious problem in traumatology and orthopedics up to the present day. Maintaining the balance between the efficiency of thromboprophylaxis and the danger of post operative hemorrhage can be achieved only when the prevention medication, its dose and the duration of use have been correctly chosen. An anticoagulant of the new generation (Pradaxa), per oral direct thrombin inhibitors dabigatran etexilate to the utmost complies with the above specified requirements that are why the authors decided in favor of its use in everyday clinical practice. A primary test for open use of dabigatran in 48 patients who underwent hip or knee arthroplasty has been carried out. Taking into account the highest risk of thromboembolic complications after large joints plasty, the method of mechanical prophylaxis DVT - electro neurostimulation of shin muscles has been introduced into clinical practice. According to the results of follow-up of the patients, who received different anticoagulants, the algorithm of an anticoagulant’s choice has been developed in various kinds of clinical situations with the possibility of changing injectable preparation to per oral forms. Convenience of per oral administration and predictability of dabigatran effect made it possible to provide consistency of hospital and out-patient stages of treatment, which also contributed to the reduction of thromboembolic complications, especially at an out-patient stage.

Aim. To evaluate the qualitative and quantitative changes in the surgical approaches to the treatment of traumatic injuries of the proximal femur. Methods. Conducted was an analysis of the introduction of modern methods of surgical treatment of patients with injuries of the proximal femur for the period from 2004 to 2010. Discussed were the variants of osteosynthesis and endoprosthetic hip replacement for fractures of the neck and the trochanteric region of the femur in 1007 injured patients. Results. Over the period of 4 years it became possible to double the surgical activity of the trauma department through systematic personnel training and through the use of new structure-designs for osteosynthesis and arthroplasty. The main problem was recognized to be the lack of a system of surgical treatment and rehabilitation of such a complex group of patients. Conclusion. The analysis of results showed the need for development of specific standards of treatment of patients with fractures of the proximal femur both in Kazan city and at the level of the Republic of Tatarstan.