Purpose: To evaluate the effectiveness of illizarov external fixator in
management of intertrochanteric fracture of femur in high risk
patients.
Methodology: 22 patients of chronic diseases with relative
contraindication for closed reduction and internal fixation were
managed by illizarov.
There were 17 male patients (77.3%), and 5 females (27.7%), 12
patients had hepatic problems 54.5% , while 6 patients 27.3% had
uncontrolled hypertension and cardiac problems , where 2 patients
9.1% had pulmonary diseases , while 2 patients 9.1% had diabetes
mellitus.
patients mean age was 65.5 years, range (30-81) years, fracture
pattern was stable Evans type 1 in 17 patients 77.3%, while 5 patients
22.7% had unstable Evans type1 .
Results: Follow up was 19 months after fracture healing, there were
no mortalities in early or late postoperative period.
In half of the patients , it was 90 days for fracture healing where in
the other 50% , 120 days needed for complete union.
Harris hip score used for evaluation of the outcome, the result was
excellent in13 patients 59.1%, while good in 4 patients 18.2%, where
fair in 4 patients 18.2%, and poor in 1 patient 4.5%.
pin tract infection was in 100% of the patients (superficial type).
Varus deformity in 3 patients 13.6%, while shortening was in 4
patients 18.2%, ranging from 1.2 cm to 1.8cm.
Conclusion: Illizarov could be considered as an alternative treatment
modality for high-risk patients with intertrochanteric fracture.
Technique is simple, safe and can be performed under regional and
even local anesthesia. |
