RESULTS OF EARLY ENDOPROSTHETICS OF THE HIP JOINT IN INDIVIDUALS OF THE OLDER AGE GROUP FOR HIP BONE FRACTURES

Аннотация

An analysis of the treatment results of 227 elderly and senile patients with femoral neck fractures was conducted. Women prevailed - 146 (64.4%), and between the ages of 60 and 80 - 183 (80.6%). To study the effectiveness of treatment tactics and assess the immediate and long-term results of treatment, two observation groups were formed: the main group - 110 patients who underwent 114 primary endoprosthetics of the hip joint in the early period of injury (up to 7 days), the control group - 117 patients who also underwent endoprosthetics of thehip jointinthe lateperiod (10 days ormore). All examined patients underwent surgery, in all cases, total endoprosthetics was performed, with cementless endoprosthetics in 70.2%, cemented endoprosthetics in 28.2%, and combined endoprosthetics in1.6%. The immediate results of treatment in both compared groups were favorable anatomical and functional outcomes in 89.5% of cases. Positive outcomes in the early endoprosthetics group were somewhat higher - 93.2%, while unsatisfactory outcomes were recorded twice lower than in the comparison group - 6.8% and 14.1%, respectively. In the long-term period of observation in both groups, excellent results were noted in only 10.4%, good results in 32.4%, and satisfactory results in 44.2% of patients. Unsatisfactory results were noted in 13.0% of patients. When comparing the main and control groups, positive outcomes were somewhat higher inthe main group - 88.3%and 85.0%, respectively. In the long-term period of observation in both groups, excellent results were noted in only 10.4%, good results in 32.4%, and satisfactory results in 44.2% of patients. Unsatisfactory results were noted in 13.0% of patients. When comparing the main and control groups, positiveoutcomes were somewhat higher in themain group - 88.3%and 85.0%, respectively. 98,7:ROTCAFTCAPMI.SECNEICSLACIDEM ,5202 , yluJ,5emuloV gro.srehsilbupcimedaca.www In the long-term period, the dependence of treatment results on the use of additional means that strengthen the stability of endoprosthesis fixation was revealed. Good treatment results were obtained in 60.9% with cement fixation, 39.1% with non-cement fixation, and 32.8% withcombined fixation. Keywords:femoral neck fractures, hipjoint, olderage group,early endoprosthetics. Material and methods. An analysis of the treatment outcomes of 227 elderly and senile patients with femoral neck fractures was conducted according totheWHOclassification. All patients received treatment in the adult orthopedics and adult traumatology departments of theRSCEMCbetween 2020and 2025. To study the effectiveness of the tactics and methods of staged treatment, and to evaluate the immediate and long-term functional results of treatment, two observation groups were formed: The main group consisted of 110 patients who underwent 114 primary endoprosthetic operations on the hip joint in the early period of injury (up to 7 days), using the treatment anddiagnosticalgorithms developed in theclinic at all stages of treatment; The control group consisted of 117 patients who also underwent endoprosthetics of the hip jointat alater stage (10 days ormore) and undertraditional management. Among the patients, women prevailed - 146 (64.4%), men - 81 (35.6%), the age of the patients ranged from 60 to 91 years. The largest number of operated patients in both groups was observed between theages of60 and 80-183(80.6%). The main cause of injury in patients of the main group was falling on the street (street trauma) - 79 (72.2%) patients. 29 (26.3%) patients suffered injuries in everyday life, falling from a height of about 1 meter (bench, table, chair, ladder), and 2 (1.5%) patients received injuries as a result of a traffic accident. In the comparison group, 84 (71.8%) patients were injured as a result of falling on the street, indoors, or in transport, 30 (25.6%) patients were injured as a result of falling from a height of their own height, and 3 (2.6%) patients were injured as a result ofatraffic accident. Analyzing the radiological examination data, it was revealed that patients with subcapital fractures prevailed in both groups - 148 (65.2%), followed by transcervical fractures - 53 (23.3%) and basal fractures - 26 (11.5%). In the main and control groups, patients with subcapital fractures ofthefemoral neck prevailed -80(72.7%) and68(58.1%), respectively. Out of 227 patients, 443 identified somatic disorders occurred, with an average of 1.95 diseases per patient. In both groups, the presence of concomitant pathology was identical, pathology from the cardiovascular system (RHD, cardiosclerosis, atherosclerosis) prevailed - 158 (72.8%), damage to peripheral vessels in the form of varicose disease of the extremities, etc. -157 (72.4%), followed bydiabetes mellitus -75 (34.6%) observations. The presence of two or more somatic deviations in the patient caused significant difficulties in planning surgical intervention, choosing anesthesia, and in the postoperative