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The scope and importance of hip fractures is almost incomprehensible. With a world wide incidence of close to 2 million cases per year, these fractures pose a daunting challenge to our ability to affect and treat this epidemic. The incidence of these fractures is predicted to grow to 6 million in 2050 including a near term baby boom spike. Add the hospital mortality rate of up to 4% and the one mortality of from 8% to 20% and the life ending effect of these fractures becomes a glaring reality. Of those who initially survive their fracture, about 50% never walk the same again. The social problem in the care of these elderly people is enormous. Of course, any real solution to this problem will include education, prevention, surgical and hospital treatment protocols, long term rehabilitative efforts, social - justments and a generous contribution of money. This publication is primarily directed to the amplification of a new treatment modality that addresses only a fraction of the problem. It is, however, a quantum leap in the evolution of fixation with compression hip screws which are still the gold standard for surgical stabilization of pertrochanteric hip fractures. The Dynamic Martin Screw (DMS) addresses the issue of adjustability of the fixation angle with appropriate mechanical strength characteristics that were la- ing in its historical predecessors.
List of contents
Conventional hip surgery in traumatology.- A century of experiments and experiences.- Technical properties of the DMS.- The analysis of hip compression screws made of implant steel under static and limit load requirements.- Implants and instruments.- Radioanatomy.- Abnormal radiographic anatomy of the proximal femur.- Fracture classification at the proximal femur.- Statistical items.- Surgical technique for fracture treatment.- Operative procedure.- Operative procedures (Case reports).- The prognosis of the femur neck fracture after headpreserving osteosynthesis.- Intermediate DMS (2/3 implant).- Stabilization of intertrochanteric fractures with the Dynamic Martin Screw (DMS).- The 31A 3-3 fracture: an unstable problem.- Subtrochanteric femur and proximal femur shaft fractures.- Application of the Dynamic Martin Screw (DMS) in the intertrochanteric osteotomy.- Distal femur fractures.- Pathologic fractures and osteolyses at the femur.- The use of an innovative femur neck prosthesis in case of complications after hip fracture surgery.- Exceptional indications.- Additional and adjuvant measurements and procedures.- Systemic antibiotics in the prophylaxis and therapy of postoperative infections in patients with osteosynthesis of the femur.- Prevention of venous thromboembolism in hip surgery.- Physiotherapy after surgery for proximal femur fractures.- Operative revisional management.- Evidence-based drug treatment of osteoporosis.- Closing remarks.
