Fractures of the upper end of the femur. Fractures of the upper end of the femur osteosynthesis is not only used for the treatment of vkolochennyh femoral neck fractures. In all other cases, for health reasons, surgery is used. This helps solve the problem of saving the lives of patients, to achieve union of fractures and the patient getting up early. Use three-blade osteosynthesis nail, L-shaped plate, cannulated screws. In some cases, must resort to a hip replacement.
Osteosynthesis is performed on the second to fourth day after the fracture. Initially, skeletal traction is applied, the patient being prepared for surgery and performed X-ray control. Task operation: exact matching fragments and their strong fixation. In the mid-femoral neck fracture fixation is carried out three-blade nail. Surgery can be open or closed. Closed-hip osteosynthesis under the control of X-rays to perform orthopedic reposition table (comparison) fragments by using special devices. The joint is not opened, a large section of tissue do not produce. Closed method introduce nail guiding his needle or a special device (electron-optical converter).
There are techniques using cannulated screws. Open method of osteosynthesis is the outcrop fracture site by a cut of the soft tissues and the introduction of three-bladed nail under direct vision. This method is associated with significant soft tissue trauma and massive blood loss, so it is used less frequently. Osteosynthesis for fractures of the lateral parts of the upper end of the femur is performed more often in older people. It uses three-bladed nail in combination with a lateral plate or L-shaped plates. Good results were achieved at present using special plates with dynamic compression screws.
Fractures of the diaphysis (middle part) of the femur. Osteosynthesis is the primary method of treatment of fractures of femoral shaft. Conservative methods are applied only in case of impossibility of surgical treatment. Most often, surgery femoral shaft performed 5-7 days after the fracture. Before operative treatment is carried skeletal traction.
Used for osteosynthesis rods, plates and external fixation devices. If the patient is serious, immediate surgery is not performed. First, normalize the overall condition of the patient. In some patients with combined injuries, comminuted fractures may require immobilization of the fragments for an urgent cessation of further injury to the thigh tissue, which may aggravate the patient's condition.
Fractures of the lower portion of the femur. Fractures of the lower section of the femoral fixation is carried out in the case of isolated fractures of the condyles of the femur. Reveal the fracture site. Broken-off fragment of the condyle is fixed by means of one or two screws. With some types of fractures are used for devices perosseous fixation.