[Differentiated therapy of proximal femoral fractures]

The operative therapy of 95 proximal femur fractures is reported, which were treated in the Kreiskrankenhaus St. Ingbert/Saar in the time from January 1st 1990 to June 30th 1991. Femoral neck fractures mainly were treated operatively by endoprosthetic replacement with hemiarthroplasty or hip total endoprosthesis. For per- to subtrochanteric femur fractures the use of the dynamic hip screw (DHS) was the treatment of choice, partly with screwing up the trochanter minor, cerclage of the trochanter major and/or with stabilization by bone cement in addition. Despite of a very high average age of the patients and a high rate of mostly severe basic illness for 80% of the fractures a sufficient stability was achieved to allow full weight bearing. 76.8% of the patients could be discharged directly from the surgical treatment. The therapeutic procedure is compared with the recommendations found in the literature. Different conceptions are discussed.