Original technique of percutaneous osteosynthesis was applied for the treatment of 24 patients with acetabular columns fractures. The achieved results were compared to the results of osteosynthesis performed using open direct reposition of bone fragments (39 patients). The efficacy of low-invasive surgery in acetabular column fractures with regard to provision of fragments consolidation, prevention of femoral head aseptic necrosis development and achievement of early medical and social rehabilitation of patients was showed. Maintenance of fragments blood supply, use of minimal surgical approach and closed reposition are considered to be the progressive direction of internal osteosynthesis development.

Analysis of long term (1-10 years) results for 64 patients aged 17-70 years with various types of acetabular fractures both isolated and in combination with multiple and concomitant injuries was performed. Operations were performed by low invasive technique using 7.3 mm diameter screws with flattened thread and threaded end 2.8 mm diameter. Excellent results by Harris scale were achieved in 45 (70%), good - in 12 (19%), satisfactory - in 7 (11%) patients. Advantages of single-step percutaneous osteosynthesis of acetabulum with fixation of other segments in multiple injuries are noted.

Analysis of treatment of 526 patients with proximal femur fractures (362 patients with femoral neck fractures and 164 patients with trochanteric zone fractures) was performed. Patients' age ranged from 34 to 92 (mean 67). Algorithm of differentiated choice of operative tactics depending on fracture characteristics and injury term was presented. Low invasive osteosynthesis of femoral neck with bundle of stressed V-shaped pins was suggested. Theoretical and practical ground of that technique was given. Stress within fixative-bone system created after osteosynthesis by V-shaped pins, provided stable fixation even in marked osteoporosis. The importance of bone mineral density evaluation for the choice of treatment tactics as well as the necessity of medicamental correction of the disturbed bone remodeling after surgical treatment was noted.

Modern approaches to the treatment of patients with acetabular fractures are considered. Peculiarities of diagnosis and surgical interventions performed for the fracture itself as well as for related complications and sequelae are presented.