LO SCALPELLO-OTODI Educational

, Volume 32, Issue 1, pp 22–26 | Cite as

Fratture del femore prossimale

  • Nicola Capuano
  • Flavio Carbone
  • Angelo Del Buono
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Proximal fracures of the femur

Abstract

The goals of a tissue-preserving minimally invasive approach to the hip are to provide early short term recovery, achieve hip joint stability, minimise muscle strength loss from surgery, spare the peri-articular soft tissues, and allow for unrestricted motion in the long term. It is indicated in case of hip arthroplasty in patients with no pre-existing hardware, with a sufficient space between the acetabular rim and greater trochanter, and for the management of subcapital femoral fractures in older patients. Contraindications include protrusio acetabuli and joint stiffness. Starting from a lateral position, a 5–8 cm incision is made from the tip of the greater trochanter, followed by identification and transaction of the piriformis tendon. Anterior mobilization of the gluteus minimus follows, together with exposure and capsulotomy of the posterior superior of the capsule. We proceed then to prepare the acetabulum. After removal of the head and neck, we prepare the femoral canal. Complete muscle relaxion is helpful to proceed to satisfactory trial reduction. As regards postoperative management, patients may progress to motion and weight bearing without restriction. From April 2009 to December 2016, the first author (NC) operated on 820 patients for subcapital fractures of the femoral neck. Seven hundred (\(85\%\)) patients could walk with full weight load within 24 hours from the operation, and climb stairs 24 hours later with low loss of blood, and fast recovery.

Notes

Conflitto di interesse

Gli autori Nicola Capuano, Flavio Carbone e Angelo Del Buono dichiarano di non avere alcun conflitto di interesse.

Consenso informato e conformità agli standard etici

Tutte le procedure descritte nello studio e che hanno coinvolto esseri umani sono state attuate in conformità alle norme etiche stabilite dalla dichiarazione di Helsinki del 1975 e successive modifiche. Il consenso informato è stato ottenuto da tutti i pazienti inclusi nello studio.

Human and Animal Rights

L’articolo non contiene alcuno studio eseguito su esseri umani e su animali da parte degli autori.

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Copyright information

© Società Italiana Ortopedici Traumatologi Ospedalieri d’Italia 2018

Authors and Affiliations

  • Nicola Capuano
    • 1
  • Flavio Carbone
    • 2
  • Angelo Del Buono
    • 1
  1. 1.Unità Operativa Complessa di Ortopedia e Traumatologia, Azienda OspedalieroAzienda Ospedaliero-Universitaria San Giovanni di Dio e Ruggi d’AragonaSalernoItalia
  2. 2.Dipartimento di Ortopedia e TraumatologiaUniversità Federico IINapoliItalia

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