Introduction: We present 25 cases of operated patients, diagnosed with trochanteric fractures of the femur, which by definition should be treated by osteosynthesis.
Materials and Methods: In these presented cases, we show an alternative method - hip arthroplasty (unipolar or bipolar), striving mainly to avoid both prolongation of bed healing and not putting pressure on the operated leg (which is needed after osteosynthesis for a period of at least 45 days).
Results: After arthroplasty, the patients can stand up and start putting pressure on the operated leg two days after the operation (50% of body weight on the operated limb for a period of 15 to 30 days, and after that - 100% of body weight). More indications for arthroplasty are:1. Definite - coxarthrosis 3th and 4th grade. 2. Relevant: a) when an early rising of old and/or frail patients is needed; b)severe osteoporosis, which would prolong the period of consolidation after osteosynthesis.
When it is possible to put weight on the operated limb earlier, the probability of complications from prolonged bed rest is lower, and delayed weight putting can cause thromboembolism, hypostatic pneumonia and decubitus ulcers.
Conclusions: We based our consideration on our database and results, comparing them with a group of 25 trochanteric fractures, operated by the method of osteosythesis. We defined arthroplasty in our study: 1. Patients with better chances to outlive the critical period; 2. A method of less complications; 3. A method, after which a second surgery is not needed.
We consider that arthroplasty after certain trochanteric fractures is a good alternative method when it is needed.
