Vol. 10, No 2, 2003 pp. 79 - 83
UC 617-089:616.71-001.5   
SURGICAL TREATMENT OF THE TROCHANTERIC FRACTURES
BY USING THE EXTERNAL AND INTERNAL FIXATION METHODS
Saša Milenković, Milorad Mitković, Mile Radenković,
Desimir Mladenović, Zoran Golubović, Miloš Stanojlović
Orthopedic and Traumatology Clinic, Faculty of Medicine, Niš, Serbia
E-mail: sasa65@bankerinter.net
Summary. Trochanteric fractures usually occur in older patients, who are more than 65 years old, with greater loss of the skeletal mass. Conservative methods of treatment are accompanied by the greater percentage of death cases; moreover, they do not render valid anatomical and functional results. Surgical treatment by using the dynamic implant presents a method of choice in the fixation of the trochanteric fractures. This paper surveys the treatment-results of the 110 patients, 61 of whom have throcanteric fractures, and have been operatively treated by the dynamic method of the internal fixation, whereas the remainder 49 patients have been treated by the method of the external fixation. Dynamical implants enable both dynamisation and compression of the fracture in the axial of the neck as well as the diaphysis of the femur, which lessens the occurring possibility of the mechanical complications, and, at the same time, enables the effective healing of the fracture, early activation and mobility of the patients who were operated. In patients infected by various diseases, for whom the surgical trauma presents a life treat, the external fixation has to be a method of choice.
Key words: Surgical treatment, trochanteric fractures, external and internal fixation
HIRURŠKO LEČENJE TROHANTERNIH PRELOMA DINAMIČKIM METODAMA SPOLJNE I UNUTRAŠNJE FIKSACIJE
Kratak sadržaj: Trohanterni prelomi nastaju najčešće kod bolesnika starije životne dobi, iznad 65. godina, kod kojih postoji veći gubitak koštane mase (osteoporoza). Konzervativne metode lečenja su praćene velikim procentom smrtnosti i ne daju dobre anatomske i funkcioanalne rezultate. Hirurško lečenje dinamičkim implantatima predstavlja metod izbora u fiksaciji trohanternih preloma. U radu se prikazuju rezultati lečenja 110 bolesnika, 61 sa trohanternim prelomima lečenih operativno metodom dinamičke unutrašnje fiksacije i 49 bolesnika lečenih metodom spoljne fiksacije. Dinamički implantati omogućavaju dinamizaciju i kompresiju preloma i u osi vrata i dijafize femura, što smanjuje mogućnost nastanka mehaničkih komplikacija, a istovremeno omogućava sigurno i efikasno zarastanje preloma, ranu aktivacuju i mobilizaciju operisanih bolesnika. Kod bolesnika koji su opterećeni bolestima, kod kojih hirurška trauma predstavlja opasnost po život, spoljna fiksacija je metoda izbora.
Ključne reči: Hirurško lečenje, trohanterni prelomi, spoljna i unutrašnja fiksacija