[Optimization of trauma care to victims of older age groups with fractures of the proximal femur.].

The objective of the study was to improve the treatment outcome of patients of older age groups with fractures of the proximal femur by developing an algorithm for providing medical care while taking into account the nature of a fracture and the comorbid background of a patient. The article describes approaches to the choice of tactics and techniques of medical assistance to patients of older age groups with fractures of the proximal femur. 4 491 patients with fractures of the proximal femur who had been treated at the Hospital for War Veterans in Saint Petersburg from 2010 to 2019 were included for analysis. All the patients were divided into two groups depending on the tactics of the treatment used. Group 1 (2 082 patients) were treated in 2010-2014 using traditional methods. Group 2 (2 409 patients) were treated according to the developed algorithm while taking into account the nature of a fracture and the severity of comorbid pathology. The results were evaluated by the Leken's functional index, and the quality of life was assessed by WHO scale. In patients of the 1st group, good outcomes were achieved after a year in 126 (10,5%), after 3 years in 111 (9,1%), while in the second group after a year, excellent outcomes were achieved in 103 (6%) cases, good in 960 (55,7%), and after 3 years excellent in 87 (5,4%), good in 843 (52,3%). Thus, the use of the proposed algorithm for providing care to patients with fractures of the proximal femur significantly (p<0,001) improves the treatment outcomes for this category of patients.