MODERN METHODS OF TREATMENT OF FRACTURES OF THE PROXIMAL FEMUR

Аннотация

Fractures of the proximal femur (femoral neck, intertrochanteric and pertrochanteric zones) are one of the most pressing problems in traumatology and orthopedics, especially among elderly patients. These injuries are accompanied by a high rate of disability and mortality, which makes it important to introduce effective, low-trauma and quickly restorative treatment methods. The modern strategy for managing patients with such fractures includes early diagnostics using radiography and CT, rapid hospitalization and individually selected treatment tactics. Surgical treatment methods are currently considered the "gold standard" for most fractures of the proximal femur. The most widely used are osteosynthesis with dynamic hip screws (DHS), intramedullary fixation with PFN and Gamma nails, as well as modular hip endoprostheses. Prosthetics is used more often in older patients or in comminuted fractures, where restoration of the anatomy of the femur is impossible. In modern practice, special attention is paid to minimally invasive technologies that reduce the volume of surgical trauma, minimize blood loss and shorten the hospital stay. Modern anesthesiological approaches, prevention of thromboembolic complications, antibacterial therapy, as well as a multidisciplinary approach to the treatment of elderly patients (geriatric orthopedics) can significantly improve treatment outcomes. Rehabilitation begins early after surgery and includes the stages of exercise therapy, physiotherapy, psychological support and drug correction of osteoporosis. An integrated approach to treatment and subsequent rehabilitation can improve the quality of life of patients, reduce the risk of recurrent fractures and restore lost functions of the musculoskeletal system. This work is aimed at generalizing modern methods, analyzing their effectiveness and prospects for implementation in clinical practice.