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The operative treatment of the each type of the hip fractures and their infucence on early morbidity and mortality


Authors: Peter Vyskočil;  Libor Paša;  Tomáš Kočiš;  Juraj Jarošík
Authors‘ workplace: Úrazová nemocnice v Brně, Traumatologické oddělení
Published in: Úraz chir. 21., 2013, č.2

Overview

INTRODUCTION:
Hip fractures are persistent social and economic problem in the aging population in developed countries. Immediate operative treat-ment - osteosynthesis or total hip arthroplasty are the methods of choice.

METHODS:
Our patient population consisted of 145 subjects (54 men) over 50 years of age with the isolated proximal femur fracture who were admitted Trauma Hospital in Brno during the year 2008. Our aim was to investigate the relationship between the fracture type and the choice of the treatment, we also studied the complications and mortality rate.

RESULTS:
Among 138 patients who underwent the surgery, in 82 (57 %) osteosynthesis and in 56 (38 %) total hip arthroplasty was performed. Conservative treatment was chosen in 7 (5 %) patients. Same day surgery was performed in 68 (83 %) patients with osteosynthesis and 23 (41 %) patients with arthroplasty. Most of the subcapital fractures were treated with the hip arthroplasty. Basicervical fractures were mainly treated with the DHS (dynamic hip screw), while in the intertrochanteric fractures the use of PFN (proximal femoral nail) was dominant. During the hospitalisation two deaths was reported, the most common postoperative complications were cardiopulmonal.

CONCLUSION:
Early intervention is crucial in those intracapsular fractures that are treated with osteosynthesis. In other cases, strict preoperative preparation of the patient is much more important and contributes to the elimination of the postoperative complications.

Key words:
hip fracture, osteosynthesis, arthroplasty, morbidity, mortality.


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Labels
Surgery Traumatology Trauma surgery
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