Background
High-risk geriatric patients with ‘intertrochanteric’ fractures are difficult candidates
for open reduction and internal fixation because of restricted availability of modern
anaesthetic techniques. The aim of this study was to analyse the results of external
fixation of ‘intertrochanteric’ fractures in high-risk geriatric patients as a safer
alternative to open internal fixation.
Patients and methods
Thirty patients of an average age of 65.9 years were treated by external fixation for their
intertrochanteric fractures. Patients in the study had Evans stable intertrochanteric
fractures and unstable fractures that could be reduced to an anatomical or nearly
anatomical position by closed manipulation under fluoroscopy. The average follow-up
period was 24 months (range 12–40 months).
Results
There were no mortality cases in the early postoperative period, but the number of
mortality cases within 6 months after surgery was seven patients (23.3%); three
patients missed follow-up and 20 patients completed the follow-up. Sound fracture
healing was achieved in all patients. The final result was satisfactory in 90% of patients
(40% excellent and 50% good), fair in 5% of patients and poor in another 5% of
patients.
Conclusion
Treatment of intertrochanteric fractures by external fixation is a simple noninvasive
procedure and can be performed under local anaesthesia together with narcotic
analgesic support. It allows early mobilization, and implant removal is easy. Therefore,
treatment of intertrochanteric fractures by external fixation is a practical solution in
high-risk geriatric patients.
Keywords:
elderly high-risk patients, external fixator, trochanteric fractures