Early mobilization in patients with intertrochanteric fracture.

: In the article the authors present results of surgical treatment of intertrochanteric fractures at their clinic with the focus on an early post-operative mobilization. In the oldest age group which involves the greatest risk as concerns the general health condition they seek such a type within the indication of surgical treatment which would allow an early mobilization. Osteosynthesis makes possible a good reduction, however, it is necessary to avoid full weight bearing, mainly in case of osteoporosis, which elderly patients are not able to manage. Hemiarthroplasty requires to reconstruct the femoral calcar by means of cementing or to apply wire loop in the trochanteric region. However, patients can start weight bearing of the limb subject to their own tolerance immediately after the surgery. This fact is considered by the authors as very important for the indication of the type of surgical treatment in the oldest age group which is also most risky from the viewpoint of their general condition. The evaluation of the gait of patients with intertrochanteric fracture prior to their dismissal from the hospital two or three weeks after the surgery showed very good results of hemiarthroplasty in 82 patients (62 %), good in 38 patients (29 %) and poor in 12 patients (9 %). In patients after fixation by a 130 degrees angled blade plate the gait was evaluated as very good in 47 patients (41 %), good in 57 patients (49 %) and poor in 12 patients (10 %).The results show that after hemiarthroplasty in the oldest age group with the average age of 83 years their gait after the dismissal from the clinic is evaluated as better than after fixation by a 130 degrees angled blade plate. Early mobilization is considered by the authors as one of basic attributes in the indication of the type of surgical treatment of fractures in the older age. Key words: intertrochanteric fracture, internal fixation, hemiarthroplasty, physiotherapy.