Treatment of patients with proximal femoral fractures. I. Orthopaedic care. Guidelines of the Czech Rheumatological Society and the Czech Society for Metabolic Bone Diseases

Authors: J. Vaculík;  P. Dungl;  T. Malkus;  M. Majerníček;  A. Podškubka;  K. Pavelka 2;  J. Štěpán 2
Authors‘ workplace: Ortopedická klinika IPVZ FN Na Bulovce Praha, 2Revmatologický ústav, 1. lékařská fakulta UK, Praha
Published in: Čes. Revmatol., 17, 2009, No. 3, p. 134-144.
Category: Recommendations for Treatment


In addition to standard surgical procedure, the success of treatment of proximal femoral fracture is influenced by further factors. The sooner surgery is carried out following a preoperative medical examination, the greater the rate of patient improvement. Prevention of infection and thrombosis is a standard part of treatment of proximal femoral fractures. As a factor in improving a patient’s postoperative development, local anesthesia is preferable. Femoral neck fractures are treated surgically by osteosynthesis, total hip arthroplasty or hemiarthroplasty, depending on the degree of fracture dislocation, as well the patient’s age and condition. Intertrochanteric and subtrochanteric fractures are treated by osteosynthesis by dynamic hip screw or intramedullary implant. In the treatment of patients with proximal femoral fractures, it is also important to look at rehabilitation treatment and the patient’s social situation. Evaluating the risk of future fractures, recommending secondary fracture prevention in patients with proximal femoral fracture should be an integral part of treatment.

Key words:
proximal femoral fracture, surgical treatment, postoperative care


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