Elderly trochanteric fractures: principles of treatment

Kim, Keun Woo; Ahn, Seong Hong

Abstract

The goal of treatment in elderly patients with trochanteric fractures is restoration of function to preoperative ambulatory status at the earliest possible time. For this purpose operative treatment is generally recommended. The success of operative treatment depends on the stable reduction and secure fixation. But osteoporosis and comminution of the fracture geometry which are common in this aged group result in various complications and preclude satisfactory results. Because of these factors many surgeons are tempteed to develop new implant designs and new modifications of the reduction. Stable reduction by either anatomic or nonanatomic means is preferred by most surgeons to lessen complications. Various sliding nail-plate devices and intramedullary nails are mainly used for fixation. Prosthetic replacement of the hip may be an altemative for osteoporotic risky patients.