Is External Fixation Valid Option for Pertrochanteric Fractures in High-Risk Patients?

Abstract

Objective: The objective of the present study was to evaluate whether surgical treatment of the pertrochanteric fractures of the femurwith external fixator could reduce the pre- and postoperative length of hospital stay, with low complications and mortality and withsatisfactory functional results to achieve rehabilitation and incorporation into the daily life in high-risk patients.Methods: Twenty-six patients who had pertrochanteric fractures were treated using the Orthofix Pertrochanteric Fixator (BussolengoVerona, Italy). There were 14 male and 12 female patients. The mean age of the patients was 73 (37–93) years. The fractures were classifiedaccording to the modified Evans classification. Of the fractures, 19 were unstable, and 7 were stable. Patients were evaluated onthe day the fixators were removed according to the Foster criteria.Results: The mean operative time was 24 (20–65) min. The average hospitalization was 12.7 (3–43) days. The average union time of the16 patients who were alive and whose fixators could be removed was 5.2 (3–11) months. Stable fractures healed at approximately 4.1months, whereas unstable fractures healed at 5.9 months. Six patients developed pin tract infection and five of them were superficial.During the 12-month follow-up period, 10 patients died from causes unrelated to the operation. The mortality rates of the 26 patientswho had intertrochanteric fractures treated with pertrochanteric fixator in our retrospective study were 23.07% within the first 30 daysand 42.3% within 1 year.Conclusion: In conclusion the use of external fixation for the management of pertrochanteric fractures in elderly patients of poorhealth is a valuable and valid alternative surgical method.