THE DIFFERENTIATED THERAPY OF PROXIMAL FEMUR FRACTURES

The operative therapy of 95 proximal femur fractures is reported, whic h were treated in the Kreiskrankenhaus St. Ingbert/Saar in the time fr om January lst 1990 to June 30th 1991. Femoral neck fractures mainly w ere treated operatively by endoprosthetic replacement with hemiarthrop lasty or hip total endoprosthesis. For per- to subtrochanteric femur f ractures the use of die dynamic hip srew (DHS) was the treatment of ch oice, partly with screwing up the trochanter minor, cerclage of the tr ochanter major and/or with stabilization by bone cement in addition. D espite of a very high average age of the patients and a high rate of m ostly severe basic illness for 80 % of the fractures a sufficient stab ility was achieved to allow full weight bearing. 76,8 % of the patient s could be discharged directly from the surgical treatment. The therap eutic procedure is compared with the recommendations found in the lite rature. Different conceptions are discussed.