[Incidence of complications and early mortality in surgical management of coxal femoral fractures].

In a retrospective study the clinical course of 393 patients treated for proximal femur fractures is evaluated. Intraoperative complications occurred in 2% whereas early complications related to the operative procedure were seen in 19.8% and unspecific complications in 36.8%. Factor analysis proved the following items to be associated with a high risk of complication: age (p less than 0.01), preexistent diseases, kind of operative procedure (p less than 0.05) and the lapse of time between trauma and operation. The extraordinary high incidence of unspecific complications is explained by the prevailing proportion of elderly patients with a corresponding multimorbidity. A decrease in complications and lethality can be achieved by early operative treatment. With regard to the necessity of early mobilization we prefer a hemiarthroplasty in fractures of the femoral neck for elderly patients. Stable pertrochanteric fractures are treated by a dynamic hip screw whereas instable pertrochanteric fractures are an indication for Ender nailing.