Metalosteosynthesis of femoral neck fractures with an internal-and-transosseous fixator

Белинов Н.В.

Abstract


Relevance. The article deals with the problem of femoral neck fractures. The average number of fractures per 100,000 people in Russia is 60. The first year mortality when using conservative treatment is 60-80%. Complications of metalosteosynthesis amount for 41.8% of cases. Among them, there is no consolidation in 23.6%, aseptic necrosis of femoral head develops in 18.3%.
Purpose. To perfect the tactics of surgical treatment of femoral neck fractures based on using new technical devices, maintaining spongy bone tissue and recovering intraosseous circulation in the neck and head of femur.
Materials and Methods. Surgical treatment performed in 39 patients with femoral neck fractures. Mean age of patients by the time of surgery was 68.7 years. Surgeries performed urgently. Reposition of bone fragments performed on an orthopedic table of original design. And a fixator of original design used for metalosteosynthesis. Rehabilitation program of six stages prescribed in the early postoperative period.
Results. The results of treatment evaluated 12 months after surgery using clinical and X-ray techniques. Function assessment performed according to W.H. Harris score system. Excellent results obtained in 23 patients, good ones – in 11, satisfactory – in three patients, and unsatisfactory – in two ones. Long-term results with follow-up period from one (1) to five (5) years studied in 29 patients. Good function without degenerative-and-dystrophic changes in the hip achieved in 74. 3%.
Conclusions. Immediate internal-and-transosseous osteosynthesis required for patients with femoral neck fractures. Reposition of bone fragments should be performed on an orthopedic table equipped with a system of skeletal traction. Rehabilitation measures should be started on the second postoperative day.

Keywords


femoral neck fracture, little-invasive internal-and-transosseous fixator, intraosseous circulation

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