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How it is expressed and treated for pertrochanteric fracture of the femur?

Pertrochanteric femur fracture is a violation of the integrity of the fabric of this bone, from the neck Foundation to the intertrochanteric line, which is the joint of the big and small skewers. This injury belongs to the group of lateral fractures and is accompanied by copious blood loss and significant tissue damage. The most exposed of pertrochanteric fractures of the persons in the age group of sixty-six years of age and older.

problema pereloma bedra

Causes damage

This type of damage to the femoral bone tissue is in most cases seen in the elderly, brittle bones due to decalcification. In addition there are several factors that can cause injuries are presented. These include:

  1. Calcium deficiency in the body.
  2. An improper diet.
  3. Pregnancy.
  4. Pathological diseases of the skeletal system.
  5. Osteoporosis.
  6. Dorozhno-transport incident.
  7. Falling to the hip from a great height.
  8. Torsion of the lower extremities.
  9. A nasty fall on his side.
  10. Strong impact on the region of the greater trochanter.
  11. Age-related conditions strength of bone tissue.

The main types of fractures

sravnenie normalnogo i smeshennogo bedraIn trauma there are several major classification systems of pertrochanteric fractures. Let's consider them in more detail. So, according to the classification of Evans, this type of damage is divided into two groups:

  1. Stable fracture is characterized by negligible damage of the so-called cortical layer, which gives the opportunity to restore stability of the bone with reduction.
  2. An unstable fracture is a severe injury in which there is oblique islana line damage or significant violation of the cortical layer, which makes stable persistent splicing bones is extremely difficult and time consuming process.

According to another classification, pertrochanteric fractures are divided into the following varieties:

  1. Impacted fracture without displacement is characterized by an inability of the lateral movement of the femur.
  2. Impacted fracture with displacement is complicated by the occurrence in the structure of the tubular bones of the rotisserie chip femoral neck. In this case, there is a visual shortening of the affected limb.
  3. Neocolony fracture with significant displacement. For this injury characterized by appreciable displacement of the femoral neck without damaging the tubular structures spit.
  4. Pertrochanteric-diaphyseal fracture with displacement in addition to the field of interthe skewers of thigh striking the bone diaphysis.
  5. Neocolony fracture without displacement is the most lightweight subspecies of this type of damage in which there is no penetration of fragments in spit and displacement of bone fragments.
  6. Intertrochanteric femur fracture is characterized by damage to the bones in the area, located between the large and small trochanter.

The third system of classification of pertrochanteric femoral fractures divides them into:

hirurgicheskaya operaciya pri perelome bedra

  1. A closed fracture, which is a violation of the integrity of the femur without damaging the muscle tissue and skin.
  2. An open fracture, which refers to the most dangerous injury of this type, as accompanied by a rich, intense bleeding.

Location these types of injuries are divided into two types:

  1. Pertrochanteric fracture of the left femur.
  2. Pertrochanteric fracture of the right thigh.

Symptoms of pertrochanteric fractures

The main feature of this type of damage is excessive bleeding, which is typical for most fractures open. There is a rapid deterioration of the General condition of the patient. In addition, this injury manifests itself in the following symptoms:

  1. A large hematoma.
  2. Swelling at the site of injury.
  3. Severe pain.
  4. Perhaps the development of a painful shock.
  5. External rotation in the injured leg.
  6. Visual shortening of the limbs, associated with the action of muscular forces on bone fragments.
  7. Limitations of physical activity.
  8. The syndrome of "adhering heel", which is characterized by the inability to support the weight of the straightened leg.
  9. Piercing pain in the hip joint while trying to move.

stroenie bedraIn the case of concomitant bleeding experience the following symptoms:

  1. Pale skin.
  2. The appearance of cold sweat on his forehead.
  3. Shallow breathing.
  4. A sharp drop in blood pressure.
  5. Possible hypotonic crisis.
  6. Bradycardia.
  7. Weak, thready pulse.
  8. Chills.
  9. Fever.
  10. Loss of consciousness.

Possible complications and consequences

Pertrochanteric hip injury constitute a serious injury that can lead to serious complications, including death. The most common effects are considered to be:

  1. Aseptic necrosis, accompanied by necrosis of the femoral head.
  2. Venous thrombosis.
  3. Education about joint with nonunionof bone fragments.
  4. Arthritis.
  5. Osteoarthritis.
  6. The formation of joint contractures.
  7. Osteomyelitis.
  8. Osteoarthritis.
  9. In severe cases a complete "immobilization" of the patient.
  10. Heavy bleeding, which is accompanied by an open fracture, can cause anemia in severe form.

http://www.youtube.com/watch?v=2W26-mZk5yg

Particularly dangerous this type of damage is for an elderly person. Pertrochanteric fracture in patients over the age of sixty years is fraught with additional complications. These include:

  1. Diseases of the cardiovascular system.
  2. Exacerbation of chronic diseases associated with prolonged immobility.
  3. The development of pathologies of the respiratory system.
  4. Pertrochanteric fracture in the elderly can cause death from pneumonia, thromboembolism or heart failure.

In order to avoid such severe consequences, the victim must provide competent comprehensive treatment and proper care during this period.

Types of diagnostics and how to treat?

Diagnosis of fractures of this type is produced as a trauma surgeon, based on General inspection and palpation method. Pertrochanteric fractures have a fairly concrete manifestations, therefore, to establish the type of damage for a specialist usually is not difficult. However, in order to determine the kind of fracture and the severity, you need the following diagnostic studies:

  1. The x-rays.
  2. Computed tomography (usually appointed in difficult cases, when x-rays do not allow to make the full clinical picture).

http://www.youtube.com/watch?v=AL90-rtzJkc

Treatment of pertrochanteric fractures are classified in two main ways:

  1. Conservative therapy is the plaster on the injured limb and stretching it with a load. The process takes about two months, and prolonged immobility can lead to the development of a number of comorbidities. Control over the General condition of the victim, as well as the correct splicing of the bone segments by the doctor treating them.
  2. Surgery. The most effective method of treatment of pertrochanteric fractures is considered to be the operation. At the same time in the damaged bone of the patient, the surgeon introduces a special pin with durable fixation. In addition, in order to fix the fragments of the femur, apply a special metal plate. This operation takes no more than half an hour, and the motor activity of the patient resumes a week after.

In General, the treatment gives favorable results.

With proper care and proper rehabilitation of the affected bone is subject tofull restoration.

The recovery period

The results of treatment must be secured with the help of a certain rehabilitation therapy. Rehabilitation lasts several months and includes the following activities:

  1. Physiotherapy.
  2. Physiotherapy.
  3. Massage treatments are available.
  4. Nutrition.
  5. Supplementation of calcium to strengthen bone tissue.

http://www.youtube.com/watch?v=V7q6jUYtUL0

Pertrochanteric hip fracture is a serious injury, which is particularly dangerous for the elderly. However, with proper treatment and compliance with medical recommendations is the possibility of complete recovery of the patient without typical manifestations of complications.