Fractures of the proximal extremity of the femur: current diagnostic and therapeutic classification overview.

Introduction Fractures of the proximal extremity of the femur are the most frequently encountered lesions in traumatology departments. Due to the progressive aging of the population, the incidence of these fractures is increasing in most Western populations (Fig. 1) to the point of reaching epidemic proportions and threatening to undermine the balance of many health care systems due to excessive treatment costs (1). These extremely common fractures are characteristically diagnosed in two patient groups: In adults, more rarely, caused by high-energy trauma, mostly due to traffic or work accidents, or occurring during sports activities. The elderly, with greater frequency, caused by low-energy trauma. In most cases, the traumatic event is an accidental fall; in some cases, when the patient is confused and poorly cooperative, it may even be impossible to determine the etiology of the fracture. The elderly, especially women, are predisposed to this type of injuries due to osteoporosis, which weakens the bone tissue by reducing the bone mass, particularly at the femoral neck and trochanteric region (2). The World Health Organization has estimated that in 2050, 6.3 million (4.6 million more than in 1990) femur fractures will occur, and it is estimated that in Italy, between 70 000 and 90 000 femur fractures are treated each year. In industrialized countries, the incidence of femur fractures is constantly increasing (by 1-3% per year), almost exclusively in the elderly population. The "lifetime risk" for hip fractures is currently about 18% for women and 6% for men. The prevalence increases by about 3% for women between 65 and 74 years of age, and by 12.6% for women older than 85. Review