Fractures of the Proximal End of the Femur in Adults at the Gabriel Toure Chu

Abstract

Introduction : This study evaluates the epidemiological, clinical, and therapeutic aspects of PFEF at Gabriel Touré University Hospital in Bamako, Mali. Methodology : This was a retrospective and prospective study involving 104 patients treated between January 1, 2020, and April 1, 2024. Results: FEPFs accounted for 26% of femoral fractures, affecting mostly men (sex ratio: 1.26) with a mean age of (61 ± 18.7) years. Good pre-fracture autonomy (mean Parker score: 7.5) was present in 83% of patients. Fractures Trochanteric fractures were common (56%), with a slight predominance on the right side. Bilateral PFEFs accounted for 3%. Domestic accidents were the main cause (47.1%). Associated injuries included distal radius and shaft fractures femoral, with four cases of staged fractures. Surgical treatment was predominant (97%), with the majority using the DHS screw-plate (50.6%) and total hip replacement (24.3%). Complications included infections (1.9%), shortenings (1.9%), and disassembly of equipment (4.8%). We recorded 18 deaths (17.3%). The functional results, evaluated in 85 patients according to the Merle d’Aubigné and Postel rating at the last follow-up (20.8 months), were satisfactory (excellent and good) in 93% of cases. Conclusion: Rapid, multidisciplinary care is essential to reduce mortality and complications while improving functional outcomes.