Yuriychuk L. Total hip arthroplasty for elderly patients with pertrochanteric and intertrochanteric fractures

The thesis is devoted to problem of rising of treatment efficiency of elderly patients with pertrochanteric and intertrochanteric fractures on the basis of differential approach to the surgery treatment choice, and to the improvement of the total hip arthroplasty method. In the thesis the analysis of treatment of 123 elderly patients with pertrochanteric and intertrochanteric fractures of the femur has been performed. The patients were of 60 - 97 years old (mean age 72,4). There were 84 (68,3 %) females and 39 males (31,7 %). The patients were assigned to 4 groups according to four different methods of fixation: cement total femoral endoprothesis (43 patients), ostheosynthesis with the help of angular plate (40 patients) or DHS (20 patients), or intramedular nail (20 patients). Long-term results and the reasons that negatively influenced the results of traditional methods of treatment have been evaluated. The structural-functional status of proximal part of the femur and the condition of the injured femur that needed surgery treatment and evaluated osteoporosis diagnosis on all the patients that underwent surgery have been investigated. The proposed method of threatment of elderly parients with pertrochanteric and intertrochanteric hip fractures and the improvement of the methodic of total hip arthroplasty allow to make the patient active in early post-surgical period and to improve the functional outcome. Correlational multi-factor analysis was performed that compared the efficacy of traditional methods of treatment and total hip arthroplasty. The total hip arthroplasty in pertrochenteric and intertrochanteric hip fractures with osteoporosis and osteoartrosis in elderly patients is preferable method.