Comparative analyses of the results obtained from operative and non-operative treatment of the trochanter fractures

Trochanter fractures rank among severe injuries of the bone tissue and are most often encountered in elderly persons who already have a number of accompanying diseases of cardiovascular, respiratory and endocrine systems. The treatment and healing of such fractures is always a relevant problem because of high frequency and specific population it most often befalls. In this paper, the results of the operative and non-operative treatments of the trochanter fractures are compared. The analyses involved 60 patients with trochanter fractures, older than the age of sixty. The patients were divided into two groups. The test group comprised 30 patients treated operatively at the Orthopedic Department of the Health Centre in Cuprija. The trochanter fractures were stabilized by dynamic intra-medullar implants (20 patients) and by static extra-medullar implants (10 patients). The control group also included 30 patients who were treated by supracondillar skeletal extension at the Clinical Centre in Kragujevac. The mean age of all patients was 70.52 years. The treatment having been completed, the final results were assessed based on Salvati-Willson's scale, which was modified by Todorovic and Jevtic. The following parameters were considered: pain, scope of movements, strength of muscles, support, walking and functioning of the injured extremity. Comparing the results of operative and non-operative treatment, it was found that operative treatment gave better results in all the analyzed parameters (time of mobilization, scope of movements of the injured hip, muscle strength, functioning of the injured extremity, shortening of the extremity, frequency of infections). Comparing the results of the operative treatment by dynamic intra- medullar fixation with the operative treatment by the rigid extra medullar fixation, we found that the treatment by dynamic fixation had better effects in all analyzed parameters.