[Comparative evaluation and current views on the treatment of trochanieric fractures of the femur in middle-aged and elderly patients].
The methods of treatment of trochanteric fractures of the femur depend on both on the peculiarities of the fracture of this part of the bone and on the general state of elderly and old people aggravated with accompanying diseases of the inner organs. The immobilization-free method was used in extremely severe cases. The mortality rate in the patients of this group was the highest. Skeletal traction still remains the main method of treating trochanteric fractures. However, this method is connected with a long period of bed rest, a danger of the development of hypostatic complications, and requires a long rehabilitation period. Surgical treatment with immersion osteosunthesis using a two or three flange nail with diaphyseal application is rather traumatic and does not allow the patients to move with a full load on the extremity at early terms, although it permits to mobilize them at earlier terms. The mortality rate is almost the same as in the treatment with skeletal traction. External perosseous osteosynthesis is low traumatic and allows to walk with a full load on the extremity at early terms, yet it requires regular observation and dressings, which prolongs the in-patient treatment period. The most prospective method of treatment of trochanteric fractures in elderly and old people is intramedullary osteosynthesis after Ender or Lezius.