Pertrochanteric fracture in a group of 41 patients was internally fixed using a DHS with a two-hole side-plate. There were 20 male and 21 female patients with a mean age of 74 years. Thirty-two patients were followed up for more than one year and their final results were evaluated. There were 30 stable (31A1) and only two unstable (31A2) fractures. The average surgical time was 28 minutes, the average length of incision was 5.5 cm. All the patients, with one exception, healed without complications in anatomical position with good function of the hip joint. The only complication was caused by pulling-out of the plate from the femur in the fourth postoperative week when the patient (31A2 fracture) fell out of bed. A DHS with a four-hole side-plate was used at reoperation; subsequently the fracture had healed. Based on the results in this series of patients, the authors recommend fixation of stable pertrochanteric fractures with DHS and a two-hole side-plate. As proven by the authors, the benefit of DHS with a two-hole side-plate as compared to DHS with a four-hole side-plate is a shorter surgical time (28 and 36 minutes, respectively).
This study examines the epidemiological data of patients with hip fractures from 1997-2007. Adult patients treated for hip fracture between the years 1997-2007 were included in the study. Retrospective statistical assessment of continually gathered data focussed on epidemiology and demographics. The study involved 3,683 patients (2,678 women and 1,005 men). Patients older than 70 years accounted for 82% of all cases. There were 2.7 times more women; in patients younger than 60 years men significantly outnumbered women (p < 0.001). The mean patient age was 77.9 years (SD ± 12.6; women, 80.3 years; men, 71.5 years). There was a slight increase in the average age in both sexes. Trochanteric fractures accounted for 54.7% and femoral neck fractures accounted for 45.3% of fractures. The ratio of men to women was the same in femoral neck (AO-31B) and trochanteric (AO-31A) fractures. The average year-to-year increase in the number of fractures was 5.9%. For femoral neck fractures (AO-31B), there was a statistically insignificant increase in the number of fractures (p = 0.63); for intertrochanteric factures (AO-31A3) there was a statistically insignificant decrease (p = 0.65). There was an increase in the number of hip fractures resulting in a significant increase in pertrochanteric fractures (AO-31A1+2) (p < 0.001). The ratio of trochanteric to neck fractures increased from 0.99 to 1.53. Continual monitoring of patients with hip fracture offers data which allows comparisons between regions and countries. There has been a continual increase in the number of patients with hip fractures.
Patients at greatest risk for a SCHF were women with limited mobility who resided in nursing homes for the elderly. The lower mortality rate associated with second fractures shows that the prognosis for such patients is good. Since the at-risk group is so well defined, prophylactic measures for these patients should be utilized in order to minimize the risk of additional fractures.
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