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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">porozendo</journal-id><journal-title-group><journal-title xml:lang="ru">Остеопороз и остеопатии</journal-title><trans-title-group xml:lang="en"><trans-title>Osteoporosis and Bone Diseases</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2072-2680</issn><issn pub-type="epub">2311-0716</issn><publisher><publisher-name>Endocrinology Research Centre</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14341/osteo13190</article-id><article-id custom-type="elpub" pub-id-type="custom">porozendo-13190</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КОНСЕНСУСЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CONSENSUS</subject></subj-group></article-categories><title-group><article-title>Междисциплинарный консенсус по оказанию помощи пожилым пациентам с переломами проксимального отдела бедренной кости на основе ортогериатрического подхода</article-title><trans-title-group xml:lang="en"><trans-title>Interdisciplinary consensus on the care of elderly patients with hip fractures based on an orthogeriatric approach</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0143-0614</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лесняк</surname><given-names>О. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Lesnyak</surname><given-names>O. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лесняк Ольга Михайловна - д.м.н, профессор.</p><p>191015 Cанкт-Петербург, ул. Кирочная, 41</p><p>Researcher ID J-5512-2013; Scopus Author ID 56769681100</p></bio><bio xml:lang="en"><p>Olga M. Lesnyak - MD, Dr Sci (Med.), Professor.</p><p>41, Kirochnaya str., St. Petersburg 191015</p><p>Researcher ID J-5512-2013; Scopus Author ID 56769681100</p></bio><email xlink:type="simple">olga.m.lesnyak@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2466-7120</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кочиш</surname><given-names>А. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Kochish</surname><given-names>A. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кочиш Александр Юрьевич - д.м.н., профессор.</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Alexandr Yu. Kochish - MD, Dr Sci (Med.), Professor.</p><p>St. Petersburg</p></bio><email xlink:type="simple">auk1959@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9951-5183</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Беленький</surname><given-names>И. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Belenkij</surname><given-names>I. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Беленький Игорь Григорьевич - д.м.н., руководитель отдела травматологии и ортопедии ГБУ «СПб НИИ СП им. И.И. Джанелидзе»; профессор кафедры травматологии и ортопедии, СПбГУ.</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Igor G. Belenkij - MD, Dr Sci (Med.).</p><p>St. Petersburg</p></bio><email xlink:type="simple">belenkiy.trauma@mail.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7955-3625</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Белов</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Belov</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Белов Михаил Викторович - к.м.н.</p><p>Ярославль</p></bio><bio xml:lang="en"><p>Mikhail V. Belov - MD, Cand Sci (Med.).</p><p>Yaroslavl</p></bio><email xlink:type="simple">micbelov@yandex.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7856-1567</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Белова</surname><given-names>К. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Belova</surname><given-names>K. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Белова Ксения Юрьевна - д.м.н., доцент.</p><p>Ярославль</p></bio><bio xml:lang="en"><p>Ksenia Yu. Belova - MD, Dr Sci (Med.).</p><p>Yaroslavl</p></bio><email xlink:type="simple">ksbelova@mail.ru</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2083-2424</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Божкова</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Bozhkova</surname><given-names>S. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Божкова Светлана Анатольевна - д.м.н., профессор.</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Svetlana A. Bozhkova - MD, Dr Sci (Med.), Professor.</p><p>St. Petersburg</p></bio><email xlink:type="simple">i@sbozhkova.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0282-7207</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Буйлова</surname><given-names>Т. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Builova</surname><given-names>T. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Буйлова Татьяна Валентиновна - д.м.н., профессор.</p><p>Нижний Новгород</p></bio><bio xml:lang="en"><p>Tatyana V. Builova - MD, Dr Sci (Med.), Professor.</p><p>Nizhni Novgorod</p></bio><email xlink:type="simple">tvbuilova@list.ru</email><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6736-9772</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Загородний</surname><given-names>Н. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zagorodnij</surname><given-names>N. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Загородний Николай Васильевич - д.м.н., профессор, член-корр. РАН, советник директора НМИЦ ТО им. Н.Н. Приорова Минздрава России; заведующий кафедрой травматологии и ортопедии РУДН.</p><p>Москва</p></bio><bio xml:lang="en"><p>Nikolaj V. Zagorodnij - MD, Dr Sci (Med.), Professor.</p><p>Moscow</p></bio><email xlink:type="simple">zagorodniy51@mail.ru</email><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1886-124X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Марченкова</surname><given-names>Л. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Marchenkova</surname><given-names>L. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Марченкова Лариса Александровна - д.м.н., доцент.</p><p>Москва</p></bio><bio xml:lang="en"><p>Larisa A. Marchenkova - MD, Dr Sci (Med.).</p><p>Moscow</p></bio><email xlink:type="simple">lr-march@rambler.ru</email><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3176-5300</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пичугина</surname><given-names>Г. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Pichugina</surname><given-names>G. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Пичугина Галина Александровна - к.м.н.</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Galina A. Pichugina - MD, Cand Sci (Med.).</p><p>St. Petersburg</p></bio><email xlink:type="simple">gal-gal2000@mail.ru</email><xref ref-type="aff" rid="aff-9"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2726-8758</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Родионова</surname><given-names>С. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Rodionova</surname><given-names>S. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Родионова Светлана Семеновна - д.м.н. профессор.</p><p>Москва</p></bio><bio xml:lang="en"><p>Svetlana S. Rodionova - MD, Dr Sci (Med.), Professor.</p><p>Moscow</p></bio><email xlink:type="simple">rod06@inbox.ru</email><xref ref-type="aff" rid="aff-10"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5272-0454</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рунихина</surname><given-names>Н. К.</given-names></name><name name-style="western" xml:lang="en"><surname>Runikhina</surname><given-names>N. K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Рунихина Надежда Константиновна - д.м.н., профессор.</p><p>Москва</p></bio><bio xml:lang="en"><p>Nadezhda K. Runikhina - MD, Dr Sci (Med.), Professor.</p><p>Moscow</p></bio><email xlink:type="simple">nkrunihina@rgnkc.ru</email><xref ref-type="aff" rid="aff-11"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2923-9712</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сафонова</surname><given-names>Ю. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Safonova</surname><given-names>Ju. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сафонова Юлия Александровна - д.м.н.</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Julia A. Safonova - MD, Dr Sci (Med.).</p><p>St. Petersburg</p></bio><email xlink:type="simple">jula_safonova@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3347-0984</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Турушева</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Turusheva</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Турушева Анна Владимировна - д.м.н., доцент.</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Anna V. Turusheva - MD, Dr Sci (Med.).</p><p>St. Petersburg</p></bio><email xlink:type="simple">anna.turusheva@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова»<country>Россия</country></aff><aff xml:lang="en">North-Western State Medical University named after I.I. Mechnikov<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">ФГБУ «НМИЦ травматологии и ортопедии им. Р.Р. Вредена»<country>Россия</country></aff><aff xml:lang="en">Vreden National Medical Center for Traumatology and Orthopedics<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru">ГБУ «Санкт-Петербургский НИИ скорой помощи им. И.И. Джанелидзе»; ФГБОУ ВО «Санкт-Петербургский государственный университет»<country>Россия</country></aff><aff xml:lang="en">Saint – Petersburg Institute of Emergency Care n.a. I.I. Dzhanelidze; Saint-Petersburg State University<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru">ГАУЗ ЯО «Клиническая больница скорой медицинской помощи имени Н.В. Соловьева»; ФГБОУ ВО «Ярославский государственный медицинский университет» Минздрава России<country>Россия</country></aff><aff xml:lang="en">Clinical Hospital of Emergency Care named after N.V. Soloviev; Yaroslavl State Medical University<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru">ФГБОУ ВО «Ярославский государственный медицинский университет» Минздрава России<country>Россия</country></aff><aff xml:lang="en">Yaroslavl State Medical University<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru">ФГАОУ ВО «Национальный исследовательский Нижегородский государственный университет им. Н.И. Лобачевского»<country>Россия</country></aff><aff xml:lang="en">Lobachevsky State University of Nizhni Novgorod<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-7"><aff xml:lang="ru">ФГАОУ ВО «Российский университет дружбы народов им. Патриса Лумумбы»; ФГБУ «НМИЦ травматологии и ортопедии им. Н.Н. Приорова»<country>Россия</country></aff><aff xml:lang="en">Peoples’ Friendship University of Russia; Priorov Central institute for Trauma and Orthopedics<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-8"><aff xml:lang="ru">ФГБУ «НМИЦ реабилитации и курортологии»<country>Россия</country></aff><aff xml:lang="en">National Medical Research Center for Rehabilitation and Balneology<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-9"><aff xml:lang="ru">ГБУ «Санкт-Петербургский НИИ скорой помощи им. И.И. Джанелидзе»<country>Россия</country></aff><aff xml:lang="en">Saint – Petersburg Institute of Emergency Care n.a. I.I. Dzhanelidze<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-10"><aff xml:lang="ru">ФГБУ «НМИЦ травматологии и ортопедии им. Н.Н. Приорова»<country>Россия</country></aff><aff xml:lang="en">Priorov Central institute for Trauma and Orthopedics<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-11"><aff xml:lang="ru">ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова»<country>Россия</country></aff><aff xml:lang="en">The Russian National Research Medical University named after N.I. Pirogov<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>31</day><month>08</month><year>2025</year></pub-date><volume>28</volume><issue>2</issue><fpage>35</fpage><lpage>55</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Лесняк О.М., Кочиш А.Ю., Беленький И.Г., Белов М.В., Белова К.Ю., Божкова С.А., Буйлова Т.В., Загородний Н.В., Марченкова Л.А., Пичугина Г.А., Родионова С.С., Рунихина Н.К., Сафонова Ю.А., Турушева А.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Лесняк О.М., Кочиш А.Ю., Беленький И.Г., Белов М.В., Белова К.Ю., Божкова С.А., Буйлова Т.В., Загородний Н.В., Марченкова Л.А., Пичугина Г.А., Родионова С.С., Рунихина Н.К., Сафонова Ю.А., Турушева А.В.</copyright-holder><copyright-holder xml:lang="en">Lesnyak O.M., Kochish A.Y., Belenkij I.G., Belov M.V., Belova K.Y., Bozhkova S.A., Builova T.V., Zagorodnij N.V., Marchenkova L.A., Pichugina G.A., Rodionova S.S., Runikhina N.K., Safonova J.A., Turusheva A.V.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.osteo-endojournals.ru/jour/article/view/13190">https://www.osteo-endojournals.ru/jour/article/view/13190</self-uri><abstract><p>Настоящий консенсус подготовлен группой экспертов различных специальностей в интересах повышения качества оказания специализированной медицинской помощи пациентам пожилого и старческого возраста с переломами проксимального отдела бедренной кости (ППОБК), которые практически всегда являются следствием остеопороза и повышенного риска падений. Сложности в лечении этой категории больных обусловлены как тяжестью самой травмы, так и коморбидностью, что сопровождается высокой летальностью и крайне низким качеством жизни выживших. Эффективное ведение таких пациентов возможно только при совместном участии врачей и медицинских сестер хирургического и терапевтического профилей в рамках так называемого ортогериатрического подхода. Эксперты в области травматологии и ортопедии, анестезиологии и реаниматологии, гериатрии, восстановительной медицины, клинической фармакологии, терапии, ревматологии и эндокринологии на основе имеющихся клинических рекомендаций и приказов Министерства здравоохранения Российской Федерации, данных литературы и общей дискуссии сформулировали основные принципы междисциплинарного ведения людей пожилого и старческого возраста с ППОБК. Цель консенсуса — помочь наладить эффективное взаимодействие врачей разных специальностей на основе лучшего их взаимопонимания, что будет способствовать улучшению специализированной медицинской помощи, сохранению жизней и снижению инвалидизации пожилых пациентов с ППОБК.</p></abstract><trans-abstract xml:lang="en"><p>This consensus was prepared by a group of experts from various specialties in the interests of improving the quality of specialized medical care for elderly and senile patients with hip fractures, which are almost always the result of osteoporosis and an increased risk of falls. Difficulties in the treatment of this category of patients are due to both the severity of the injury itself and comorbidity, which is accompanied by high mortality and extremely low quality of life for survivors. Effective management of such patients is possible only with the joint involvement of doctors and nurses of surgical and internal medicine and geriatric profiles within the framework of the so-called orthogeriatric approach. Experts in the field of traumatology and orthopedics, anesthesiology and intensive care, geriatrics, rehabilitation, clinical pharmacology, therapy, rheumatology and endocrinology based on the available clinical recommendations and orders of the Ministry of Health Care of the Russian Federation, literature data and general discussion formulated the basic principles of interdisciplinary management of elderly and senile people with hip fracture. The aim of the consensus is to help establishing effective interaction between professionals of different specialties based on their better mutual understanding, which will contribute to improving specialized medical care, saving lives and reducing disability of elderly patients with hip fracture.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>ортогериатрия</kwd><kwd>переломы проксимального отдела бедренной кости</kwd><kwd>специализированная помощь</kwd><kwd>консенсус</kwd><kwd>пожилой возраст</kwd><kwd>старческий возраст</kwd></kwd-group><kwd-group xml:lang="en"><kwd>orthogeriatrics</kwd><kwd>hip fractures</kwd><kwd>specialized care</kwd><kwd>consensus</kwd><kwd>elderly</kwd><kwd>senile age</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Комплекс мер, направленный на профилактику падений и переломов у лиц пожилого и старческого возраста / О.Н. Ткачева, Ю.В. 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