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Vol. 23, Art. 40 (pp. 679-693)    |    2022       

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Peculiarities of providing traumatological care to elderly, senior and long-livers with fractures of the proximal femural

Kucheev I.О.1, Linnik S.А.1, Kashansky Y.B.2, Kondratev I.P.2, Polikarpov А.V.1,
Лапшин В.Н.2

1 Hospital for veterans of wars, Saint-Petersburg, Russia,
2 Saint-Petrsburg I.I. Dzhanelidze research institute of emergency medicine, Russia.

Brief summary

The article presents modern approaches to the choice of strategy and technique of medical care for victims of older age groups (elderly, senile age, centenarians according to WHO criteria) with fractures of the proximal femur (S72.0, S72.1, S72.2. according to ICD 10). The tactics of their treatment was determined, which showed the expediency of expanding the "window of vital indications" to the operational allowance for these injuries. It has been established that such an approach, based on objective assessments of the general status and severity of the comorbid background of the victim, ensures the admissibility and safety of surgical treatment in the acute period of traumatic disease, despite the introduction of additional trauma. The study included 2409 patients with fractures of the proximal femur treated at the Veterans Hospital from 2014 to 2019. All patients were provided with trauma care based on the developed algorithm, taking into account the nature of the fracture and the severity of comorbid pathology. Complications and anatomical and functional parameters were studied to assess the immediate results of treatment. Long-term outcomes of trauma care were assessed using the Lequesne scale [21]. It was found that only after 6 months in 7% of patients the results were unsatisfactory. At the same time, only 2% of the victims died. Thus, the conducted study showed that the use of the proposed program for providing medical care to patients with PPCL can significantly (p < 0.05) improve their treatment rates.


Key words

elderly and senile patients, proximal femoral fracture (PPTF), comorbid background, dynamic prediction, strategy, tactics.

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