Methods of surgical treatment of trochanteric fractures

Abstract

Aim of the study. Evaluation of the surgical treatment of trochanteric fractures obtained during 2013-2015. Materials and methods. During 2013-2015, 119 patients with trochanteric fractures (Evans classification) were treated in the Department of Orthopaedia from the Institute of Emergency Medicine and the Hospital from Balti. The study group consisted of: 79 females (66.4%), 40 males (33.6%). The mean age was 75.96 years. Out of the total number of patients, 101 patients (84.9%) underwent surgical treatment. The following fixation was applied: DHS – in 35 cases, 95’ blade-plate – in 17 cases, 135’ blade-plate – in 3 cases, DCS – in 5 cases, Gamma nails – in 14 cases, PFN – in 17 cases. Thirty-one patients (30.7%) were treated by minimally invasive methods. Results. Immediate results were appreciated by X-ray, distal results were appreciated using the Harris Hip Score. Division of the results was: good in 46 cases, satisfactory in 10 cases, non-satisfactory in 2 cases. The following complications were encountered: joint stiffness in 2 cases, slow consolidation in 3 cases, pseudoarthrosis in 2 cases. Non-satisfactory results were found in patients treated with plates. Mean value of the Harris Score was 86%. Conclusions. The rate of trochanteric fractures is higher in males than in females. Osteosynthesis with PFN and Gamma plates are reasonable in treating trochanteric fractures. Intramedullary nails are characterized by minimal trauma, minimal hemorrhage and minor risk of perioperative complications. Fixation methods with different dynamic fixators show good results.