Changes and progress in the treatment of fractures of the coxal end of the femur

: Consideration of technical developments, a review of the literature and of our own experience with 535 patients compared with nearly 20,000 patients of an ASIF population treated during the same period show that the indications for treatment of extra- and intracapsular fractures of the proximal femur have become much simpler. (1) Extracapsular fractures of the proximal femur fall into two groups: pertrochanteric fractures are fixed by means of the dynamic hip screw and intratrochanteric unstable fractures by means of either the dynamic hip screw (valgus type) or a 95 degrees condylar plate. (2) Intracapsular fractures are treated according to the patient's age group. In patients younger than 70 years femoral head preservation is achieved by compressing screw osteosyntheses, while in patients over 70 years head resection is performed an a total endoprothesis inserted. In patients with life expectation shorter than 3-5 years a femoral head prothesis is inserted.