Aims. Unipolar and bipolar femur head replacement in the cases of proximal femur fractures is considered one of the most common surgical procedures. But the most often post-op complication is the acetabulum cartilage erosion. The aim of this research was to estimate the speed of cartilage erosion two mentioned above surgical operations. Methods. The follow-up of 75 patients after unipolar and 62 after bipolar in the period of 24–30 (average 25.6) months post-op was performed. The average age was 78 + 13,5 years. To increase the correctness of measurement we have used the method of computer-assistant evaluation of X-ray þlms, proposed by the author. X-ray þlms were scanned. After it the special virtual ruler was placed to the scanogram to measure needed data. The presence of the artiþcial joint in the pelvis area with known sizes of its components have given the opportunity to þt the virtual ruler according to the size of artiþcial joint (for example Ð prosthesis head diameter). Results. To get the cartilage wear speed we estimated þrst the height of the cartilage before the surgery. It was 4.55 mm in average and depended on the level of degenerative processes in the hip. The average follow-up period was 25.6 months. In this period both groups have shown the wear of the acetabular cartilage. The average cartilage erosion speed in the þrst (unipolar) group was higher (1.3 mm in 2 years) then in the second (bipolar) Ð 0.6 mm in 2 years. The erosion speed increased in the presence of preoperative signs of degenerative processes in the hip and depended on its level. Conclusions. Mentioned above data shows that bipolar hip replacement causes less destructive processes in the acetabulum than unipolar.

Aims. The treatment of the proximal femoral fractures in the elderly people is connected with the presence of the marked somatic pathology, the forced supine position of the patients leading to hypostatic complications. According to the data of numerous studies one and only way to save such patient is to perform the early operative treatment. Methods. We made the analysis of treatment of 642 elderly and senile patients with the proximal femoral fractures, to which the unipolar or bipolar hip replacement was performed. The age of the patients was 51 to 96 years (average Ð 79,2). The operative procedures were performed as the urgent ones independently from the periods passed after the trauma. In connection with the periods of the operative procedure after trauma, all the injuried were divided into 5 groups: operated during the þrst day (219 patients), in 2–3 days (138 patients), in 4–6 days (89 patients), in 7–10 days (92 patients) and more than in 10 days (104 patients). As the principal criterion for the comparison we took the in-patient lethality. Results. The total lethality was 7,6% (49 patients). In the þrst group it was 4,1% (9 patients), in the second Ð 6,5% (9), in the third Ð 8,9% (8), in the fourth Ð 15,2% (14) and in the last Ð 8,7% (9). According to the performed analysis the lesser percentage of the lethal results was deþned in the case when the operative procedure was performed during the þrst day after trauma. Conclusions. Thus the main principle of the treatment of the patients with the mentioned pathology must be the early operative procedure performed during the þrst day after trauma. The late admission to the hospital is connected with the increasing of the operative risk, some part of the injuried die due to the underestimation of their status, insufþcient technical equipment of the specialized departments and some time due to the medical mistakes.