[Fractures of the proximal femur in patients over 70 years--choice of procedure and results].

From 1978 till oct. 1981 110 patients between 70 and 99 years old were operated upon fractures of the proximal femur. Out of those 43 presented with fractures of the femoral neck, 46 with pertrochanteric, and 17 with subtrochanteric. In fractures of the femoral neck we generally perform alloplastic replacement of the femoral head or total hip arthroplasty. By means of a 24 hour preparing period (volume and electrolyte replacement, digitalis) and intraoperative administration of dopamine the systemic reaction to bone cement could be avoided. Pertrochanteric fractures are treated by Ender- rods immediately. Subtrochanteric fractures are the greatest technical problem. We now use long-stem-prosthesis as compound-osteosynthesis. Physiotherapy is applied aggressively. The patients are trained to walk from the second day p.op. on. Perioperative lethality rated 17%. Within the group of age 70 till age 80 only four died (7,5%), over 80 years 15 (30% of this group). Following hip-replacement there were 13 deaths, after Ender-rods only 4 lethalities. 83% of all patients could be discharged after a mean of 19 days, 86% of those ambulatory.