Proximal femoral factures: current management options and principles

Ugnė Kėvalaitė1, Simas Gindriūnas1, Emilis Zavickas2

1Lithuanian University of Health Sciences, Medical Academy, Faculty of medicine, Kaunas, Lithuania

2Asklepios Klinikum Schwalmstadt, Department of Orthopedic and Trauma Surgery, Schwalmstadt, Germany


Background. Hip fractures are one of the leading causes of hospitalisation in elderly patients, which will cause an increasing socioeconomic problem in the future, especially considering the increasing number of elderly people in our country. Due to the increase in the burden of this disease, true challenge remains in the prevention and in the developement of new strategies to improve quality of life for this group of patients.

Aim: to review information on current clinical management of proximal femoral fractures and principles as reported in the literature.

Methods. Literature sources were selected from PubMed and ClinicalKey medical databases using these keywords: proximal femoral fractures, hemiarthroplasty, surgical management, treatment.

Results. The main objectives when treating proximal hip fractures should include an early surgery, adequate pain control, balanced fluid management. Trochanteric and subtrochanteric fractures favour intramedullary nailing as first choice of treatment. In the case of femoral neck fractures, hemiarthroplasty or total hip replacement surgery are recommended, and the type of endoprothesis is usually chosen regarding the physical ability and age of the patient.

Conclusions. Proximal femoral fractures remain a major concern for both patients and health systems. The main focus should adequate pain control, early mobilization, thromboprophylaxis and appropriate selection of the operative method. When choosing a surgical treatment method the patient‘s age, activity level and co-morbidities should be taken into account.

Keywords: proximal femoral fractures, hemiarthroplasty, surgical management, treatment.

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