Zlomeniny trochanterického masivu - klinické, anatomické a biomechanické aspekty, možnosti terapie, komplikace

• Main Author: Bartoška, Radek
• Other Authors: Báča, Václav
• Format: Doctoral Thesis
• Language: Czech
• Published: 2016
• Online Access: http://www.nusl.cz/ntk/nusl-347510

Hip fractures are mainly problems of the elderly population. The incidence in the Czech Republic is one of the highest in the world. They include a pertrochanteric fracture. One possibility of its therapy is intramedullary nailing. The advantages of the nailing is allowing a sliding effect of the proximal fragment which leads to better contact between fragments. Surgical procedure has its own risks and complications. We decided to evaluate a group of patients with pertrochanteric fractures treated in 2009-2011 with the PFN Medin. We analyzed the sliding effect and factors which can influence it and complications. The study cohort covers 304 patients. We found out that the sliding effect was in 195 cases (67.1%). The type of the fracture did not affect the sliding. There was no significant difference depending on the length or screw placement in the proximal fragment. We found following complications:3 medial displacement (0.9%), 6 varus collapses (1.9%), 4 necroses of the head of the femur (1.3%) , 13 cases of the femoral neck resorption (4.3%), 10 fractures around the nail (3.2%), 4 Z- effects (1.3%) and 3 "cut-out" phenomena (1.0%). We have created a model of stable and unstable fractures with the finite element method. The analyzes focused on the placement of the neck screw, showed that in stable...