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Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
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[Mortality in patients with proximal femur fractures undergoing conservative and surgical treatment]
I I Shubnyakov1, T N Vorontsova1, A S Bogopolskaya1
1Vreden National Medical Research Centre for Traumatology and Orthopedics, St. Petersburg, Russia.
Objective:
To study the incidence of proximal femur fractures (PFF) in St. Petersburg and survival rate depending on treatment strategy.
Material And Methods:
Considering the data of long-term monitoring of traumatology and orthopedic service in St. Petersburg, we assessed the incidence of PFF in adults and various treatment options. Moreover, we have studied all patients admitted to 2 large hospitals in St. Petersburg between December 2017 and December 2018 for at least 14 months. There were 914 requests for medical care for PFF from 903 patients.
Results:
Mean incidence of PFF in St. Petersburg is 0.88 per 1000. The discharged patients without surgical care make up 20%. About 37.5% and 42.4% of patients require hip arthroplasty or osteosynthesis, respectively. Postoperative mortality was 3.5%, in-hospital mortality after therapeutic management - 9.1% (p=0.016). Two-year mortality after osteosynthesis was 27.2%, after hip arthroplasty - 19.3%, after conservative treatment - 43.9% (p<0.001).
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