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In terms of frequency, trochanteric fractures represent one of the most common problems in adult traumatology. Considering their physical and psychological consequences, and the patients mean age, they constitute one of the most acute public health problems faced by the elderly. Surgical reduction is currently considered as preferred treatment. Stable fixation of the fracture focus by osteosynthesis allows early mobilization of the treated member, central axis of the body. A series of 35 patients with a mean age of 78, surgically treated with Gotfried percutaneous plating between June 1998 and August 2000, have been followed-up to full fracture healing. The fractures were divided according to the AO fracture classification system. All patients were treated with this minimally invasive technique, which consists of introducing a percutaneous compression plate through two tiny stab incisions. The results take into account the reduction quality, mean hospital stay, evolution, perioperative and postoperative complications. The patients early weight bearing has been possible from the third day after the operation. The mean perioperative blood loss was estimated to 90 mL. The mean mortality rate during hospital stay was 5.7%, and 11.4% after three months. The complications encountered comprised two cephalic screw cutouts, two plate breakages and one surgical wound infection. Linked to the quality of the bone, regardless of the material used, these complications are likely to those observed with other methods. This short sample allows to consider the percutaneous compression plating as a valid surgical technique, though it can be opposed the same critics than other trochanteric fractures treatments. However, it offers the benefits of a closed and rapidly performed surgical technique, theoretically beneficial to improve the vital prognosis for this type of fracture.

One of the factors determining the stability of osteosynthesis is the mechanical strength of the bone fragments required for the anchorage of the implant. The aim is to study the driving of a Thornton nail in the proximal epiphysis of a human femur as a way to measure the strength of the trabecular bone and to predict the stability of the implanted system.

The factors influencing mortality and morbidity were analysed in a series of 224 elderly patients with hip fractures. It was found that mortality was influenced by the high age, the number of medical antecedents and the number of general complications occurring following surgery. Mortality rate was high in mentally deteriorated patients with a gain in autonomy in only 25% of the cases. On the contrary, mortality was less, and there were few modifications of the mental status in patients who were mentally normal upon admission. The recovery of total or partial autonomy in this group was 69.9%, justifying therefore the surgical intervention.