Treatment strategies for proximal femur fractures in osteoporotic patients.

Fractures of the proximal end of the femur, together with vertebral fractures, are greatly exacerbated by osteoporosis and can be regarded as the most typical and most serious complications of this disease. The demand for prompt mobilisation with full loading of the affected limb, combined with a desire for the gentlest of treatments, becomes increasingly difficult to meet in ageing patients with advanced osteoporosis. The advantages of osteosynthesis in respect to these demands when operating on elderly patients with fractures do not apply due to the inability of the osteoporotic bone to hold the osteosynthetic components sufficiently until fracture healing occurs.