The trochanteric fracture of the femoral tissues is characterized by damage to the femoral neck up to the trochanter. Such injuries of the lower extremities are called lateral and are accompanied by severe bleeding and violation of the integrity of adjacent tissues.
Description of this disease
Most often, a pertrochanteric fracture occurs in the elderly, but in middle and young age this injury is much less common. Such a fracture of the femoral bone is more typical for the fair sex. It is older women who come to the traumatologist with such damage more often than men.
Despite the severity of the injury, such an injury threatens with less consequences than a broken femoral neck. This is due to the fact that with an injury to the femoral bone with a displacement, parts of the fragments can grow together correctly on their own. When a fracture of the femoral neck occurs, the supply of bone structures with blood stops andindependent fusion is not possible. A trochanteric fracture of the femur in the elderly is of great danger, since the risk of complications is quite high. In particularly severe situations, such an injury can be fatal.
Main causes of pathology
Fracture of the femur of a closed type can occur when falling to the side, with a directed blow to the trochanter, or when twisting the limb. In addition, there are a number of factors that can provoke a pertrochanteric leg fracture:
1. Calcium deficiency in the body.
2. An unbalanced diet and the abuse of unhe althy foods.
3. Gestational period.
4. Bone TB.
5. Malignant neoplasms.
6. Osteomyelitis or osteoporosis.
7. Changes in the body of an elderly patient of a degenerative nature.
In the region of the femoral bone structures, pathological fractures occur more often than traumatic ones.
Types of damage
Transtrochanteric and intertrochanteric fractures of the femur are identical and require the same prescriptions for treatment, so they are not divided into several groups. There are several main types of damage in this area of the human skeleton:
1. Intertrochanteric with hammering without displacement.
2. Intertrochanteric without driving in with offset.
3. trochanteric with hammering without displacement.
4. Transtrochanteric fracture of the femur with displacement without impaction.
5. helicalpervertelny.
6. Displaced pertrochanteric fracture of the diaphysis.
Injury can demonstrate stability while avoiding significant damage to the cortical layer. Most often, a displaced pertrochanteric fracture of the femur is characterized by a lack of stability. Restoration of bone structures after receiving such an injury can last quite a long time. In addition, this type of injury has a poor prognosis, especially for older patients.
Fracture symptoms
With a pertrochanteric fracture (ICD 10) of the bone structures of the thigh, a person develops a pronounced pain syndrome of a high degree of intensity. The injured leg swells, it is not possible to stand on the limb. In addition, the so-called sticky heel syndrome occurs, when a person in an upright position cannot tear his leg off the bed even after an anesthetic injection. When a limb is forced to turn, a sharp pain in the leg occurs.
In case of a trochanteric fracture of the femur with or without displacement, the vessels of the circulatory system are always damaged, which is accompanied by the appearance of a bruise that gradually spreads over the entire surface of the damaged femur. In addition to these symptoms, there is dizziness and weakness, pallor of the skin, which is due to internal bleeding. In some cases, a person with a fracture can lose up to a liter of blood. If, during a fracture, one fragment is driven into another, the symptoms are not so pronounced and the patientable to lean lightly on an injured leg.
First aid for this disease
It is very important to give first aid to a person who has broken his hip. The success of rehabilitation therapy in the future will depend on the timely measures taken. It is forbidden to move or transport a person with a pertrochanteric fracture (ICD S72) without first fixing the injured limb. If the leg is not immobilized and fixed in one position, the fragments can disperse and complicate the treatment of the fracture.
In order to avoid consequences and complications, the splint for transportation is superimposed on the area from the waist to the heel from the outside and from the heel to the groin from the inside. Boards, umbrellas or sticks can be used as a tire. Particularly careful fixation is required at the knees and waist.
To prevent traumatic shock in a pertrochanteric fracture, the patient is given an anesthetic. It would be optimal to make an intramuscular injection into the injured thigh, but without medical skills, it is better not to risk it. Before you start providing first aid to the victim, you should call an ambulance, describing what happened in detail. You can not panic and try to do everything quickly, you must be careful and accurate when applying a splint.
How a fracture is diagnosed
In order to clarify the diagnosis, the traumatologist conducts a visual examination and palpation of the injured hip. The conclusion is made on the basis of the revealed shortening of the broken limb, as well as strengtheningthe intensity of the pain syndrome when tapping the heel. Next, the patient undergoes an x-ray examination, which allows you to determine the type and location of damage. If fragments are found, computed tomography is performed, which makes it possible to assess the degree of damage by bone fragments to adjacent tissues, including muscles, blood vessels, ligaments and nerve endings. In addition, blood and urine tests are ordered.
Treatment of this pathology
A trochanteric fracture of the femur is not life-threatening. In most cases, after the rehabilitation period, patients return to normal life and do not lose their ability to work. Fragments of the bone grow together relatively quickly, due to the fact that the nutrition of the vessels of the periosteum is not interrupted. The treatment is quite simple, but there is a high risk of complications due to a long stay in the supine position. A patient with a hip fracture may present with signs of congestion, pneumonia, and bedsores. Due to the high likelihood of severe complications, patients with a trochanteric fracture of the femur often require surgery.
Conservative methods of treating a hip fracture involve wearing a plaster cast and stretching the skeleton with weights. The bandage is applied for a period of up to two months. Stretching takes the same amount of time. Experts are trying to reduce this period for older patients, as they have a much higher risk of complications.
Operation
In some cases it may be necessarycarrying out the operation. Thanks to surgical manipulations, it is possible to shorten the recovery period. The most important aspect of bone healing is taking care of the injured leg for several months.
The task of surgery is to compare bone fragments and fix them with special pins, plates or staples. Any fixing elements are made individually on the basis of the obtained x-ray. Successful recovery depends on a number of factors:
1. Locking device model.
2. Correct matching of fragments.
3. Type of fracture.
4. Complications.
5. The quality of bone structures.
If a patient has osteoporosis or other pathologies of the musculoskeletal structures, there is a possibility that another operation will be needed. The following diseases are contraindications for surgical procedures:
1. Kidney or heart failure.
2. Heart disease.
3. Changes in the atherosclerotic type, a tendency to form blood clots.
4. Disorders in the endocrine system.
5. Increased content of purines in the body.
Most often angled plates and dynamic screws are used to fix fragments. The advantage of the latter is that during movement, the load is distributed over the bone and keeps the screw in the normal position. In other cases, the latches do not distribute the load, which makes them unusable over time. In suchthe situation will require another operation, the purpose of which will be to replace the fasteners.
Pins are often used in the treatment of fractures in older patients. This design is installed through small incisions. After the operation, the patient is shown wearing a special bandage that does not allow the leg to twist. Already two weeks after the operation, the patient can begin to stand on his leg and do some exercises.
Rehab
The recovery period after the completion of conservative treatment reaches two and a half months. It is recommended to move during the rehabilitation period only with the use of crutches. Throughout the treatment, the specialist needs to control the process of fusion of bone fragments, as well as the general condition of the patient. In old age, the restoration of damaged tissues is much more difficult, and complications can be unpredictable.
Additional procedures
To speed up the recovery of damaged bone structures, the patient is prescribed several procedures. Their implementation helps to improve blood supply and restore muscle tissue and bones. The most common prescriptions for fractures are:
1. Massage.
2. Laser stimulation.
3. Hydrotherapy.
4. Warming up.
5. Electrophoresis.
6. Paraffin therapy.
7. Therapeutic gymnastics.
Complete restoration of the functions of damaged bone tissue can occur in six months. In particularly difficult cases, rehabilitation reaches a deadlineat 12 months.
Prognosis for this disease
The forecast is quite favorable. The skewers are better supplied with blood than the femoral neck, so the bones fuse faster. It is these fractures that often do not require surgery.
The prognosis for trochanteric hip fracture in the elderly is also favorable, but if help and treatment are timely.
Find out what people say about this disease?
Reviews about this pathology
Most of the reviews about the treatment of a trochanteric fracture of the femur are left by relatives of patients who broke the hip in old age. Most often, bone tissue fuses, provided that all the recommendations of a specialist are followed.
Traumatologists note that the most important thing during the recovery period is to start developing the damaged joint in time, as this will ensure its normal operation in the future. In general, doctors are of the opinion that a pertrochanteric hip fracture in the elderly heals on its own and does not require the use of surgical methods of treatment. However, when the risk of serious complications is high, the surgeon may decide to perform an operation.
Patients note that maintenance therapy plays a big role in the recovery period, including taking calcium supplements, vitamin complexes and preventing pressure ulcers. Avoid traumatic situations, try to maintain joint mobility and flexibility as much as possiblelonger, strengthen bone structures and take care of overall he alth.
