股骨颈骨折的低创伤性经皮接骨术

Abstract

Femoral neck fractures are among the most common in elderly and senile patients and require hospitalization in a trauma hospital. In modern conditions, it is generally accepted that the treatment of femoral neck fractures should be surgical. This is due to the extremely high rates of hypostatic complications in case of refusal to perform the operation. However, extensive traumatic surgery is not always justified in the presence of severe somatic pathology in the patient. Delay or cancellation of the operation dramatically increases the risk of complications associated with physical inactivity and the risk of a lack of fracture consolidation, aseptic necrosis of the femoral neck and the formation of a false joint. In order to activate patients as soon as possible, it is recommended to perform the operation as soon as possible. There are many methods of osteosynthesis, as well as arthroplasty, however, for patients with severe somatic pathology, we have proposed a minimally invasive method of percutaneous osteosynthesis of the femoral neck with needles without the need for traumatic open reposition. According to the proposed method, 10 patients with femoral neck fractures were treated, for whom extensive surgery, such as open reposition, osteosynthesis or arthroplasty, was contraindicated or there was a need to delay them in order to correct concomitant diseases. Active surgical tactics in relation to this group of patients made it possible in all cases to activate the patient as quickly as possible, to avoid the development of delirium and hypostatic complications. The use of the proposed method of osteosynthesis in debilitated patients makes it possible to simplify treatment, minimize the risk of perioperative complications, reducesurgical trauma and blood loss.