Bogomolets National Medical University

1. Lower extremity injuries

2. Fractures of the proximal femur.
Fractures of the proximal epimetaphysis of the
femur are divided into two major groups:
internal (medial) - and external (lateral) joints.
The boundary for such distribution is the place
of attachment of the capsule of the hip joint -
linea intertrochanterica.
Intra-articular fractures are divided into fractures
of the head and neck of the femur.

3. Severe intra-articular injuries, occur as a result
of high-energy traumatic force and are almost
always part of the combined injury of the hip
joint (from 10% to 75%) - posterior dislocations
or fractures-dislocations of the thigh, fractures
of the acetabulum. Compression fractures of the
femoral head usually accompany anterior
femoral dislocations.
Fractures of the femoral head

4. Classification of head fractures by AO / АSIF.
C1 - fracture of the femoral head in the area of attachment of
the round ligament: C1.1 - separation of a small bone
fragment at the site of attachment of the round ligament;
C1.2 - detachment of the round ligament and fracture of the
head with a small bone fragment; C.1.3 - separation of a
significant bone fragment at the site of attachment of the
round ligament.
C2 - compression fracture of the femoral head
with separation of the round ligament: C2.1 -
posterior-upper part; C2.2 - front-upper part;
C3.3 - upper.
C3 - fracture of the femoral head with a
fracture of the neck: C3.1 - combined fracture
of the head and compression neck; C3.2 - head
and subcapital fracture of the neck; C3.3 -
compression fracture of the head and fracture
of the neck.

5. SCHEME OF SURGICAL TREATMENT

6. Fractures of the femoral neck
are 6-8% of the total number of skeletal fractures and up to 68% in relation to
the femur. In 90% of cases it is elderly patients (over 65 years), women
suffer three times more often than men

7. Classification of
femoral neck
fractures
by localization
by changing the
NFA
by Garden
by F.
Pauwels

8. Positive is the symptom of "stuck heel"
increased pulsation of the femoral artery, the
great acetabulum is above the Roser-
Nelaton line, with valgus - below;
Schumacher's line at varus passes below a
navel, at valgus - above, disturbance of an
isosceles triangle of Brian is defined
Clinical picture

10. Transtrochanteric fractures
and fractures of trochanter area
Among injuries of the musculoskeletal system, these fractures account for about 6%, and from
the number of victims with fractures of the femur up to 52%. Such fractures are more common
in elderly patients (66 years to 76 years and older), in women 4-6 times more often than in men.

13. Treatment

14. These injuries account for 6-
8% of all fractures of the
femur and refer to high-
energy injuries that occur
with FFD, falls from a height,
etc.

15. Treatment

16. The frequency of knee cap fractures in the
structure of injuries of the musculoskeletal
system is from 1.5% to 2%.
Knee cap (patella)
fractures.

17. .
8.9% to 11% in relation to fractures of the tibia and up to 87% among
fractures of the knee joint. In this group, fractures of the lateral condyle
occur in 52% to 80% of cases, medial - up to 7%, and many fragmentary
fractures - in 41% of patients.
Fractures of the proximal epimetaphysis of the tibia

18. Treatment

19. The share of these fractures in the
structure of injuries of the
musculoskeletal system is up to
14%.
Diaphyseal fractures of the tibia

20. Treatment

21. Fractures of the distal epimetaphysis of the
tibia. Injuries of this localization occur up
to 30% among injuries of the
musculoskeletal system and up to 80% in
relation to traumatic injuries of the ankle
joint.
Fractures of the distal epimetaphysis of
the tibia.

22. DIAGNOSTICS

23. TREATMENT

24. Malleolus fractures These fractures account for up to 80% of ankle injuries. Fractures of both
malleolus occur in 20-25% of cases, and in 5-10% - are combined with a fracture of the
anterior or posterior edge of the distal epimetaphysis of the tibia.
Supination-eversion and supination-adduction
Pronation-eversion and pronation-adduction

25. Typical fractures
Dupuytren’s
Mezonev’s
Volkmann’s

26. Three-malleolus fracture

27. Treatment

28. Peripheral fractures
А - Lateral
process
Б – medial
wall
В –
posterior
process
Г – Head
Д – vault of
the block

29. Central fractures
А –
fracture of the
neck or body
without
displacement
B –
fracture of the
neck or body
without
displacement
C – fractures and
multifragmentary
fractures

30. SURGICAL TREATMENT

31. account for up to 60% of forearm bone injuries and 2-4% of all
musculoskeletal fractures.

32. INTRAARTICULAR FRACTURES

33. TREATMENT

37. BAYKOV’S APLEY’S
McMURREY’S
SHTEYNMANN’S