Surgical Treatment of Fractures of the Trochanteric Zone of the Femur in Older Patients

Abstract

Summary. Treatment of fractures of the trochanteric zone of the femur in the elderly still remains one of the problems that need further study. Objective: to analyze clinical application of internal osteosynthesis for fractures of the trochanteric zone in older and senile patients. Materials and Methods. The results of treatment of 102 older patients with fractures of the trochanteric region of the femur were analyzed. All patients were treated surgically using a proximal femoral nail antirotation (PFNA); the indicators at the inpatient stage of treatment and long-term consequences up to 3 years after treatment were analyzed using improved standards for evaluating the quality of treatment of injuries and diseases of the organs of movement and resistance with modification. Results and Discussion. Analyzing the treatment of 102 patients with fractures of the trochanteric region type A1, A2, A3 according to the AO classification, it was found that surgical treatment with the use of PFNA proves its effectiveness due to minimally invasive access, minimal intraoperative blood loss, a short time of surgical intervention, and the possibility of early activation of patients and provides low rates of postoperative complications and mortality. Conclusions. 1. The conducted clinical study allows us to confirm the effectiveness of the PFNA system in the surgical treatment of older patients with fractures in the trochanteric zone in a trauma hospital. 2. In older patients with fractures of the trochanteric zone of the femur, PFNA osteosynthesis allows restoring the function of the hip joint in 54.6% (55% СІ 85.4-55.8) of cases. 3. PFNA can be recommended as a priority in the treatment of older patients with fractures of the trochanteric region of the femur in a trauma hospital.