[Osteosynthesis of proximal femoral fractures. Experience in the treatment of 2012 patients].
Between 1973 and 1990 a total of 2012 patients with fractures of the proximal femur were operatively treated at the surgical accident and emergency department of the Städtische Krankenanstalten Krefeld. The most commonly observed fracture in the high age group (mean: 81.2 years) was that of subcapital femoral neck (n = 1067). A total hip replacement (TEP n = 768) or a hemiarthroplasty (n = 135) was indicated in 85% of the cases. All patients in which a head preserving internal fixation was possible, were normally treated as an emergency with a cancellous screw (n = 81) or stabilized with 130 grade angled plate (n = 83). Pertrochanteric femur fractures (n = 715) were mainly stabilized with 130 grade angled plates (n = 605). In subtrochanteric femur fractures (n = 230) a 130 grade angled plate (n = 155) or a 95 grade condylar plate (n = 75) was used. In principle early internal fixation followed by immediate mobilization was the aim in all patients (68% of patients were operated on within three days of admission). Sufficient stability was achieved using internal fixation to allow full weight bearing in 76% of the injures, or partial weight bearing in 21% postoperatively. The paper shows that the patients need spend less time in the hospital (60% stayed less than three weeks on the ward, 80% were discharged within four weeks) and that the mortality in this study was reduced to 10.1% in comparison with formerly studies. Complications such as fracture of the implant (0.5%) and dislocation (0.9%) were described. The rate of bone infection amounted to 0.9% of all operations.
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Städtischen Krankenanstalten Krefeld, Abteilung für Unfallchirurgie.
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D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001863:Bone Screws; D002648:Child; D004434:Early Ambulation; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies
Die Osteosynthese der proximalen Femurfraktur. Erfahrung bei der Behandlung von 2012 Patienten.