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OVERVIEW
The number is impressive, to say the least, and is based on the meta-analysis of the epidemiological data from 1970 through 2009: By the year 2050, hip fractures will reach 4.5 million cases worldwide (Marks, 2010). The explanation lies in the aging of the population (age, osteoporosis and falls are considered the main risk factors), while researchers underline that new studies should be conducted, which shall examine other determining factors, such as the social and economic situation of the elderly. On the other hand, the hip fracture can even be found in young people who have been involved in a traffic accident, or have fallen from a high height.

HIGH RISK GROUPS
According to the Medical Matters journal of the Thessaloniki Medical Association, in Greece, these fractures are estimated at 13,000 cases per year, with an increased incident of 2,000 cases per five years. Despite the fact that, now, there is great scientific progress, and a variety of modern, special surgical approaches, they are considered a leading cause of morbidity and mortality worldwide - it is estimated that 27% of elderly women who have suffered a hip fracture die within the first year.

WHICH IS THE BEST TREATMENT?
Given that hip fractures are considered the most severe ones, among osteoporotic fractures, surgical treatment is always required to restore the length and rotation of the lower extremity. Regarding the recovery procedure, in addition to the patient’s age, the level of activity, the medical history and the concomitant conditions, the injured area are also taken into account.
Hip fractures are classified into two major categories: the intra-articular (femoral head and neck fractures) and the extra-articular (petrochanteric, subtrochanteric) ones. In the first category, the head of the femur is replaced by a metallic one, while, in the second category, the surgeon uses a special plate and screws. If we are talking about a young and active patient, the surgeon tries to preserve the head by any means, usually using retaining screws.

ΥΠΑΡΧΟΥΝ ΤΕΧΝΙΚΕΣ ΕΛΑΧΙΣΤΗΣ ΕΠΕΜΒΑΤΙΚΟΤΗΤΑΣ;
Nowadays, modern minimally invasive arthroplasty techniques are thought to greatly reduce complications and post-operative claudication - international epidemiological studies have shown that 20% have poor mobility, a year after the fracture. One of these is the SuperPath™ (posterior, percutaneous, minimally invasive hip technique), which is applied to femoral head fractures.
Its main advantage is that the surgeon does not cut any blood vessels and leg nerves until they reach the joint, and the muscles are simply “pushed back” without getting injured. As a result, post-operative pain is significantly reduced, as is the period of hospitalization and rehabilitation, and the patient can still stand up and walk with crutches, even a few hours after surgery. In the literature it is also referred to as MicroHip, due to the small incision (6-7 cm), but mainly due to the protection of the soft tissues surrounding the joint. Younger patients are considered the best candidates.
In Greece, this technique was first used in December 2016 at the Metropolitan Medical Center. Its main advantage is that the chances of dislocation, which the most serious complication, are reduced, so there is no need for postoperative restraints and precautions in the movements (pelvic-tilt device, hip abduction pillow). Using this technique, given the lack of injuries during surgery, postoperative pain is less, and recovery is more rapid.

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