The cervico-capital endoprosthesis in traumatology. Experience of the Traumatology and Special Surgery Research Institute 1985-1990
Palarcík, J.; Kalandra, S.; Kocúr, I.; Bucek, P.
Rozhledy v chirurgii mesicnik Ceskoslovenske chirurgicke spolecnosti 71(6): 294-303
1992
ISSN/ISBN: 0035-9351 PMID: 1509314 Document Number: 397154
The authors submit an analysis of a group of 143 patients to whom in 1985-1990 in the Traumatological Research Institute in Brno a cervicocapital endoprosthesis was implanted. Indication for implantation was in all instances a fracture of the neck of the femur, most frequently a subcapital fracture--a total of 92. Women predominated 5:1. The mean age was 75 years, the range 37-93 years. In 119 patients the endoprosthesis was implanted on account of a new injury, in the remaining 24 on account of the sequelae of an injury. In 32 patients 1-4 operations preceded. The most frequent cause was a fall in the home. Fifteen patients were operated on the day of the injury and 80 were operated within five days after the injury. In the group 60 complications were recorded, 1-4 complications in 46 patients (32% of the group). The causes of complications are discussed. During the investigation 46 patients died (32% of the group), incl. half during the first hospitalization on account of the investigated injury. Only 27 patients of the group could be followed up, results are presented (excellent and good in 20 patients) and the reasons are discussed why patients cannot be followed up. Finally the authors conclude that in future it will be necessary to indicate endoprostheses as primary treatment more frequently, although secondary operations have similar results. The operation should be made as soon as the patient's condition permits it; the urgency is not acute as in syntheses; it should permit early mobilization of the patient. The unsatisfactory percentage of complications must be reduced by a complex of measures starting with organization of the workplace and the regime of the operating theatres and ending with the technical skill of the surgeon. The authors emphasize the problem of subsequent rehabilitation but do not analyze it in the present work.