Doctor trauma surgeon
Roman Horobets
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Femoral trauma

Fracture of femoral bone neck

This kind of trauma is the most wide-spread among aged people. It is connected with osteoporosis and bone tissue elasticity loss. If the neck has been broken near the head, such kind of fracture is called subcapital one, if it has been broken nearby trochanter, it is called lateral one. Femoral neck subcapital fractures knit quite worse which is caused by blood supply peculiarities in this zone. Aseptic necrosis of a head often occurs in subcapital fracture even after its knitting. In this case endoprosthetics is directly indicated. Femoral neck may be fixed with cannula screws, plates with 130 0 angle, Gamma system and DHS. In aged people in subcapital fractures in connection with quite low possibility of knitting endoprosthetics may be carried out from the start. It allows full loads immediately after operation, which is of great importance for motility regimen support.

Перелом шийки стегна у пацієнта похилого віку, остеосинтез системою Гамма

Femoral bone pertrochanteric fracture

Symptomatology of this trauma reminds the same in femoral neck fracture and includes shortening of a limb, external rotation in horizontal position and inability to rise a leg. Opposite femoral neck throchanteric zone is perfectly supplied with blood, therefore perthrochanteric fractures are easily knitted. It is extremely important to restore an angle between the head and diaphysis in time of reposition as it influences allocation of load and segment durability. In connection with huge draft of muscles closed reposition and holding of fragments are impossible in this case, that’s why in majority of cases femoral fractures are treated operatively (if somatic state of the patient is satisfactory).

trochanteric fracture, plate fixation

Femoral diaphysis fracture

Femoral bone diaphysis fracture is characterized by strong dislocation due to segment length and draft of muscles. During many years these traumas have been treated with skeletal traction with the following immobilization with a body cast. After prolonged immobility contractures of joints and tissues atrophy develop. Modern implants and materials allow to fix bone fractures of any complexity preserving blood circulation and fragments vitality. Bone plates with block screws provide stable osteosynthesis, intramedular rods allow early load. Fixation method choice depends on fracture type, localization, concomitant pathology and peculiarities of an organism. 

Перелом діафізу стегнової кістки, остеосинтез, лікар Горобець

Femoral bone condyle fracture

Distal femoris fractures may be intraarticular and abarticular. They are usually treated operatively. Dynamic condyle screws, angle stable plates with LISS system, retrograde pins and L-shaped plates are used for fixation. Early functioning of a knee joint is main priority in rehabilitation of these fractures as far as prolonged immobility leads in contractures development.