Osteosynthesis of the neck of the hip

Osteosynthesis is the surgical fusion of bone fragments of the neck of the thigh with the help of various fixing structures. They can provide long-term elimination of bone mobility. The purpose of osteosynthesis is to ensure a strong fixation of fragments in the original, correct position until complete fusion. The method is the main one in the treatment of fractures of long tubular bones and is only possible with complex intraarticular fractures.

Features of operation

Nails, pins, screws, screws and spokes are used as fixatives. They are made of materials, biologically, chemically and physically inert. As a result of the operation, the most favorable conditions are created for the complete fusion of the fracture of the base of the femoral neck. Recovery comes about a fifth month after osteosynthesis. Already the next day after surgery, the patient starts walking on crutches, but the full load on the leg can be resolved no earlier than five months after the operation.

Like any surgical operation, the osteosynthesis of the base of the femoral neck has its drawbacks. The most important of them is the risk of non-brittle hand. Even if the operation itself was successful, it can not be ruled out that the fracture may not grow together. Usually, the older the patient, and also the more time since the trauma has passed, the higher the risk of non-occurrence or formation of a false( blind) joint in the neck of the thigh.

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Patients over 65 years of age try to avoid this kind of surgery at all because of the high risk of subsequent non-growth of the femoral neck. To these patients different methods of endoprosthetics are applicable. Although the operation gives, nevertheless, more chances for a full recovery. Wound healing and bone fusion are very individual, there is no exact scheme or instruction - each person has his own percentage of risk and his medical predictions.

Osteosynthesis methods

Transosseous external compression-distraction osteosynthesis on the femoral neck is performed with the help of compression-distraction apparatus. This method allows you not to expose the fracture zone and exclude the risk of displacement of fragments. The patient soon has the opportunity to move with full load on the aching limb. Fixators( spokes or nails) are conducted through the bone fragments perpendicular to their axis.

Submersible osteosynthesis is an operative introduction of bone fixators directly into the fracture focus. Depending on their location with respect to the bone, this method is intramedullary( intraosseous), normal and percutaneous. When carrying out intraosseous osteosynthesis, different kinds of fixation rods are used, and for the bone - plate with screws and screws. With transosseous ostiosynthesis, screws and spokes are used. Sometimes a combination of several types of osteosynthesis of the femoral neck is possible.

Intraosseous osteosynthesis

It is closed and open in its type. In the case of closed osteosynthesis, after the fragments are compared through a small incision along the conductor, a lock is inserted under the control of the X-ray. When an open fracture zone is exposed, the fragments are re-inserted, a fixator is inserted into the bone channel of the damaged bone.

Bone osteosynthesis

It is produced with the help of fixing plates of various thickness and shape. Plates are connected to the bone with screws and screws. Sometimes when carrying out bone osteosynthesis, metal wire, tapes, rings and semirings are used as the fixative. In very rare cases - soft suture material( silk or lavsan).

Complications of

The main complication of osteosynthesis of the base of the femoral neck( strictly speaking, not the actual carrying out of osteosynthesis, but directly fracture) is osteoarthrosis of the hip joint, as well as osteonecrosis of the avascular head of the thigh. The frequency of such complications strongly depends on the age of the patient, the characteristics of his fracture and the time that elapsed from the moment of injury to the operation itself.

In addition to these complications, in the patient after osteosynthesis of the femoral neck, the following can develop:

  • a sudden infectious process in the operated area( diagnosis rate 0.5%);
  • pulmonary arterial thromboembolism( a fatal complication, extremely rare - 0.05%).

Despite this, osteosynthesis in the region of the femoral neck has been and remains the most effective way of restoring the patient's ability to work. Only such an operation can return it to a full life. And the fear of complications here goes to the secondary plan.