Surgical prosthetic treatment

Abstract

Fragility fractures typically occur in elderly patients related principally to osteoporosis. A significative percentage of these fractures have to be treated surgically but comorbilities are often present, and need to be grossly stabilized before surgery. However, there is for these fractures a high rate of morbidity and mortality at short-term. Moreover, patients affected by a fragility fracture are at risk for another fragility fracture later in life.The Authors present an overview of the main patterns of proximal femoral fractures, underlining the peculiar features and choices of surgical treatment, and relating to specific indications and results of each treatment.

Figure 1

a, b - a: Garden 1 type femoral fracture in a 61 years old male patient. b: Fixation with three partially threaded screws.

Figure 2

a, b - a: Garden 4 type femoral fracture in a 80 years old female patient. b: Unipolar cemented prosthesis.

Figure 3

a, b - a: Garden 3 type femoral fracture in a 76 years old female patient. b: Bipolar cemented prosthesis.

Figure 4

a, b - a: Garden 4 type femoral fracture in a 62 years old male patient. b: Total hip cemented arthroplasty.

Figure 5

a, b - a: Garden 3 type femoral fracture in a 60 years old female patient. b: Total hip cementless arthroplasty.

Figure 6

a, b - a: Trochanteric fracture in a 77 years old female patient. b: Open reduction and internal fixation with sliding hip screw.

Figure 7

a, b - a: Trochanteric fracture in a 75 years old female patient. b: Open reduction and internal fixation with intramedullary nail.

Figure 8

a, b - a: Trochanteric fracture in a 70 years old female patient b: Open reduction and internal fixation with intramedullary locked nail and helical blade.

Figure 9

a, b - a: Complex trochanteric fracture in a 79 years old female patient. b: Total hip cemented arthroplasty with a calcar reconstruction implant.