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Minerva Ortopedica e Traumatologica 2006 August;57(4):361-5


language: Italian

Hip fractures: our experience in surgical treatment

Mellano D. 1, Grosso E. 1, Tarello M. 2, Vigna Suria M. 2, Massè A. 3, Biasibetti A. 1

1 A.S.O. CTO CRF M. Adelaide Dipartimento di Ortopedia e Traumatologia U.O.C. di Traumatologia Muscolo Scheletrica e Fissazione Esterna, Torino 2 I Clinica Ortopedica e Traumatologica Scuola di Specializzazione in Ortopedia e Traumatologia Università degli Studi di Torino 3 U.O.S.D. di Traumatologia Complessa del Bacino, Torino


Aim. Trochanteric region fractures are a very commmon injury in elderly. These fractures require a considerable public investement and seem to represent a major cause of health conditions’ worsening.
The aim of this study was to evaluate the level of indipendence, the mortality and the deambulatory ability in patients affected by fracture of the trochanteric region.
Methods. Since october 2002 to September 2005 we treated 349 patients with proximal femur fractures. Eighty-three patients were included in the study: 4 neck fractures, 63 intertrochanteric fractures, 13 intersubtrochanteric fractures and 3 subtrochanteric fractures. Mean age of the patients was 75.75 years (21-98). The authors evaluated the preinjury health condition, the mortality, the rate of implant failure and the functional recovery.
Results. Patients underwent different kind of surgical procedure: 4 DHS, 4 endovis, 4 external fixators, 34 gamma nails second generation, 3 gamma nails third generation, 33 PCCP and 3 PFN-A.
Mean follow-up was 22.93 months. Mortality in the first year after surgery was 14.45%. The rate of mechanical failure was 7.04%. One patient (1.2%) experienced a deep wound infection. Thirty patients (36.1%) returned to the preinjury level of indipendence.
Conclusions. Trochanteric fractures’ treatment needs a continuous effort to improve the mechanical properties of the devices and the tecnical ability of the surgeon. Each fracture must be carefully analized and classificated before surgery. Prevention is the best treatment, but when fracture accured is mandatory to minimize operative trauma and to use a mini-invasive surgical technique to allow early functional recovery.

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