[Treatment of trochanteric femoral fractures with double dynamic internal fixation].

ABSTRACT

INTRODUCTION: Trochanteric fractures are extracapsular fractures of the proximal femur. The increasing number of trochanteric fractures is a great sociomedical problem. These fractures usually occur in elderly people (older than 65 years) with osteoporosis. Lateral and frontal falls are the most frequent cause of trochanteric fractures in the elderly. The aim of this paper is to present our results of applying the Mitkovic selfdynamisable internal fixator (SIF). MATERIAL AND METHODS: From January 2001 to December 2005, 238 patients with trochanteric femoral fractures were treated operatively using the Mitkovic selfdynamisable internal fixator at the Clinic of Orthopeadics and Traumatology in Nis. The average patient age was 69, 11 years (range 17 to 88). In the analyzed group there were 152 (64%) female and 86 (36%) male patients, whereas patients in the eighth 101 (43%) and seventh 65 (27%) decade of life prevailed. RESULTS: Excellent results in the treatment of trochanteric femoral fractures with a Mitkovic dynamic internal fixator were achieved in 143 (60%) patients, good in 49 (21%) patients, poor in 41 (17%) and unsatisfactory in 5 (2%) patients. DISCUSSION AND CONCLUSION: The treatment of trochanteric fractures may be operative and nonoperative. The aim of the operative treatment, considered to be the "gold standard" for these fractures, is to restore the patient's pretraumatic activity level and to reduce life-threatening complications. The operative stabilization is performed using various types of implants. Surgical treatment by using dynamic implants is a method of choice in the treatment of trochanteric fractures. Internal fixation using the Mitkovic selfdynamisable internal fixator is a method of choice in the treatment of trochanteric femoral fractures, providing dynamization and compression of the fracture site in two axes (axis of the femoral neck and femoral diaphyseal axis) and balanced biomechanical 3D.