Introduction of modern surgical methods of treatment of patients with fractures of the proximal femur

Introduction. Currently, most orthopedic traumatologists consider surgical treatment as the method of choice for fractures of the femoral neck. However, despite the constant modernization of the available methods of osteosynthesis, the proportion of unsatisfactory outcomes of surgical intervention and the occurrence of early postoperative complications remains quite high (from 28 to 45%) [1]. One of the main directions for solving the problem of unsatisfactory outcomes of osteosynthesis is the improvement and strict control of measures taken in the postoperative period, including early activation of the patient. Despite the importance of the recovery period, there are still no unified standards for managing patients with hip fractures, and the available treatment protocols contain only a generalized plan for further therapeutic measures that do not take into account the individual characteristics of the patient. We have proposed a method for calculating the optimal load on the limb in the postoperative period. The purpose of this publication is to describe a clinical case of the effective application of the method for determining the optimal range of loads on a limb after surgical treatment of femoral neck fractures.Materials and methods: the study used materials from medical records and instrumental studies of the traumatology department of the TOGBUZ "City Clinical Hospital of Kotovsk", the results of dynamic observation for 12 months in a patient with a transcervical fracture of the femoral neck, for which the method we developed for determining the optimal range was applied. load on the limb after surgical treatment of injury.Results: 12 months after the operation, the patient who used the method for determining the safe load range in the recovery period achieved full functional and anatomical recovery of the operated limb. Full body weight bearing was allowed from the 6th month.Conclusion: the method for determining the safe range of load on the limb after a femoral neck fracture has been tested in practice and led to a positive result, which may indicate its effectiveness.

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The Interdependence of Medical-Epidemiological and Anamnestic Characteristics of Patients with Proximal Femur Fractures

Hurbanova¹

2020

Ukr. ž. med. bìol. sportu

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Many studies have confirmed that the incidence of fractures of the proximal femur increases significantly with age and doubles every ten years after the age of 50. It was found out that these patients average age increases by one year every five years, and more than 50.00% with damage to this location are over 60 years old. The purpose of the study was to determine the regional correlation features of the interdependence of medical-epidemiological and anamnestic characteristics of patients with proximal femur fractures. Material and methods. To achieve the main goal, we conducted a retrospective study of patients with such fractures according to seven medical institutions in Kharkiv. Results and discussion. When studying the correlation levels of interdependence between various medical-epidemiological and anamnestic characteristics of the examined patients we stated that the female sex correlated with all age periods, which confirmed the predominance of females among the examined all age categories: the sex of patients determined reliable (average <0.001); forces correlation with age characteristics: k = 0.349; the possible influence of gender characteristics on the choice of treatment tactics was stated reliable (p = 0.003); the inverse weak correlation with the type of treatment was recorded: k = -0.041; the possibilities of the influence of age characteristics on comorbid burden; the presence of concomitant pathology and the choice of treatment tactics were clarified: it was determined that the age of the examined patients was significantly (p = 0.014) inversely weakly correlated with the presence of comorbidities and comorbid burden (respectively k = -0.050 (p < 0.001) and k = -0.047 (p <0.001)) and the type of treatment: k = -0.193 (p <0.001); possibilities of influence of more significant comorbid burden on indicators of levels of functional condition and increase in duration of terms of receipt to traumatological departments and reception of qualitative medical care were established: reliable (p <0.001) direct weak correlation was received between indicators of age of trauma and presence of concomitant diseases k = 0.081), comorbid load (k = 0.087) and functional state according to the ASA classification (k = 0.084); determined the stable effect of the existing concomitant pathology and comorbid burden at the level of functional status and its possible impact on using conservative treatment: the presence of comorbidities correlated strongly with comorbid burden (k = 0.989, p <0.001); functional state was evaluated according to ASA classification k = 0.985, p <0.001) and directly weak with the type of treatment (k = 0.228, p <0.001); a direct strong correlation was found between the comorbid burden and functional status according to the ASA classification and the type of treatment performed (respectively k = 0.979 and k = 0.226; p <0.001); the possible influence of low functional state on the choice of treatment tactics was stated: it was proved that the functional state significantly weakly correlated with the type of treatment: k = 0.229, p <0.001. Further research is planned to establish the possibility of predicting the use of treatment tactics and the development of reliable prognostic statistical models of the dependence of the results of different treatment methods on the medical-epidemiological and anamnestic characteristics of patients

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Introduction of modern surgical methods of treatment of patients with fractures of the proximal femur

Cited by 3 publications

References 1 publication

Calculation and application of a safe range of load on the limb in patients after osteosynthesis of the femoral neck

Calculation and application of a safe range of load on the limb in patients after osteosynthesis of the femoral neck

Clinical case of applying a safe loading range to a limb in a patient with a femoral neck fracture

The Interdependence of Medical-Epidemiological and Anamnestic Characteristics of Patients with Proximal Femur Fractures

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