Transtrochanteric hip fracture in the elderly
Disease / / August 12, 2017
- Classification and especially hip fractures
- Treatment transtrochanteric fracture
- Surgical treatment
Femur - the largest of the long bones in the human body, broad and dense enoughstructure, it is simply obliged to have enormous strength.At the young age of fractures of the femur is rarely diagnosed, the cause of their heavy-duty shocks are in accidents and falls from a great height.Over the years, the body is the mass rearrangements hormonal status and metabolism, as a result of which the bones lose calcium and become brittle.
transtrochanteric hip fracture in older people - a very common phenomenon, and the cause may be even a minor trauma such as a fall in icy conditions or accidental blow.And in women, this pathology is registered in 7-8 times more often than men.The fragility of the fairer sex is due to the massive bone loss of calcium during pregnancy and childbirth, as well as hormonal imbalances during menopause.
Classification and especially hip fractures
Large and small femoral trochanter located at the medial surface of the hip joint, which causes pronounced swelling and swelling in injuries.Because this area of bone covered with periosteum, rich in blood vessels, fracture rarely has complications and quickly grows together with adequate treatment.X-rays allow us to determine the nature of the injury and to choose the right direction of treatment:
- impacted fracture.Lateral hip abduction with a slightly limited, shortening the legs is weak.
- intertrochanteric type can be both without bias and with a substantial divergence bone fragments.Much pain and bruising in the affected area is almost entirely limited mobility, coxa vara syndrome (limb shortening) is not expressed.
- transtrochanteric hip fracture with displacement - the most common of all types.Lateral movement loses limitations neck base deep into the spongy structure of the greater trochanter, which causes a visible shortening of the legs in relation to the healthy.
- transtrochanteric displaced fracture, without the introduction of the femoral neck is also quite common and has similar clinical characteristics, but the divergence of fragments of bone can be very significant, which requires much skill from the specialists when combined.
- transtrochanteric-diaphyseal fracture captures not only spit, but also diaphysis bone, often reaching up to mid-thigh.The symptoms of pain and lateral rotation are less pronounced than in other types.
By the nature of soft tissue injuries closed fracture is more common with severe signs of hematoma - a dense swelling and severe morbidity.Some patients have had symptoms and anemia - 500-700 ml of blood is a serious loss to the elderly of the human body.
addition to pain and swelling in the area of the injury, there is a characteristic syndrome "stuck heel" - the person can not lift his leg from a prone position, even with anesthesia.Trying to force the rotation leads to sharp pain.
These symptoms may be accompanied by more serious injury - a hip fracture.Therefore, to establish an accurate diagnosis requires X-ray examination.
Treatment transtrochanteric fracture
transtrochanteric fracture itself is not a serious threat to life and disability - bone, receiving power from the vessels of the periosteum, with the right combination heals relatively quickly, for 1.5-2 months.Complicate the course of the treatment of the disease can only be encountered in the long lying sick - pneumonia and congestion in the lungs, sores and skin damage compression.Therefore, at present conservative treatment is used only in cases where surgery is not available:
- acute cardiac and renal failure;
- chronic heart disease;
- atherosclerosis and thrombophlebitis;
Conservative treatment is carried out by blending the cast and skeletal traction with a load of up to 10 kg, in which the patient will spend 7-8 weeks, depending on the type of fracture.Rehabilitation after treatment extends over 2-2.5 months, during which time only allowed to walk on crutches.
very important nuance of conservative treatment is the need of constant medical supervision, not only for the coalescence of bones, but also the general state of the patient: elderly people prone to stagnation and colds, which often leads to complications and even death.
Surgical treatment allows the patient to stand up and be back up to speed in a week, with only one condition - the rejection of excessive loads over 2.5 months.The technique consists in fixing the bone debris with metal pins, staples, or plates.
tool for fixing is made exclusively on the patterns drawn up on X-ray images with millimeter precision.The success of surgery is largely determined by the implant model, combining faithfulness to the bone portions and quality of bone - in the presence of osteoporosis, the risk of complications and the need for extremely high reoperation.
High quality implants and adequate operative treatment of fractures transtrochanteric allow quick mobilization of the patient and eliminate the risk stratification of other diseases.
12 Aug, 2017