Experience in the application of minimally invasive percutaneous internal fixation for fractures of the proximal part of the femur

Abstract

Introduction. Fractures of the proximal part of the femur are one of the most common fractures, especially for elderly patients. Most of them are low in energy and occur on the background of osteoporosis. Femoral neck fractures are one of the most frequent causes of hospitalization of patients in the trauma department. The treatment of fractures of the proximal part of the femur must be surgical. During fractures of the trochanteric region, there is a tendency to have a good consolidation of the internal fixation thanks to a rich vascularization of this region. The success rate of consolidation of femoral neck fractures is lower, which imposes the need for the use of the prosthesis. However, it is not always possible to carry out a major traumatic operation due to the presence of a serious somatic pathology of the patient. The need to delay the surgical intervention may be the cause of the development of hypostatic complications and the absence of fracture consolidation, which, in turn, may aggravate the patient's condition and provoke the development of irreversible complications. In addition, the absence of fixation of the fracture induces the presence of the syndrome of strong pain that makes the quality of life of the patient worse. With the aim of rapid activation of patients with severe pathology, it has been proposed to use a minimally invasive means of percutaneous femoral neck internal fixation using pins without incising the skin and without open repositioning.The aim of the study: to evaluate the results of therapy obtained using the method of percutaneous minimally invasive osteosynthesis in patients with fractures of the femur in the proximal section.Materials and methods. According to the developed and presented method, therapeutic manipulations were performed for a fracture of the femur in the proximal section in 16 senile and long-livers patients, in whom extensive surgery was contraindicated or there was a need to delay it.Results. The treatment performed avoided thromboembolic complications, hypostatic complications in 94 %of cases and intraoperative delirium.Conclusion. The application of early fracture fixation increases the success rate of fracture consolidation compared to conservative treatment, which activates the patient, reduces pain and improves the quality of his life.

Keywords

• transtrochanteric fracture
• femoral neck fracture
• internal fixation
• minimally traumatic operation
• patient activation