High-risk geriatric patients with “inter-trochanteric” fractures remain a difficulty for open reduction and internal fixation. , due to restricteded availability of modern anesthesia.
The aim of this study was to analyze the results of external fixation of “intertro-chanteric” fractures in high-risk geriatric patients.(as a safer alternative to open internal fixation in high risk geriatric group of patients)
Patients and methods:
Thirty patients with an average age of 65.9 years were treated by external fixation of intertrochanteric fractures. Patients in the study had Evans stable intertrochanteric fractures and unstable fractures that could be reduced to anatomical or nearly anatomical position by closed manipulation under fluoroscopy. The average follow-up period was 24 months (range, 12 to 40 months).
Results:
There was no mortality in the early postoperative period, but the mortality within six month following surgery was 7 patients (23.3%) and three patients missed follow up, 20 patients completed the follow up. Sound fracture healing was achieved in all patients. The final result was 90% satisfactory (40% excellent and 50% good), 5% fair and 5% poor result.
Conclusion:
Treatment of intertrochanteric fractures by
external fixation is a simple non invasive procedure and can be done under local anesthesia together with narcotic analgesic support. It allows early mobilization, and implant removal is easy. Therefore treatment of intertrochanteric fractures by external fixation is a logic solution in high-risk geriatric patients
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