External fixation of trochanteric fractures of the femur.
Introduction: Recent published studies have compared the use of external fixation in elderly patients with trochanteric fractures with the more conventional methods of fixation such as sliding hip screw. This is the first prospective study to report outcomes of external fixation in a larger patient population which includes young and healthy adults. Materials and Methods: 200 patients with intertrochanteric fractures were treated with a newly developed uniplanar external fixator (AlexFix®). All patients received local anaesthesia in the form of femoral and lateral cutaneous nerve blocks. 60 patients were males and 140 were females with a mean age of 71.09 (24 to 91) years. Patients were followed up for a period of 24 ± 2.1 months. Results: Average operative time (and standard deviation) was 26.22 ± 5.9 minutes. Average use of radiation intra-operatively was 16.67 ± 3.5 seconds. Hospital stay was short with an average of 4.3 ± 1 days. No intra-operative complications were encountered. Blood loss was negligible and none of the patients received any blood transfusion. Mean time for union was 10.5 ± 1.1 weeks. The most common post-operative complications encountered were superficial pin tract infection in 16 patients (8%) and deep pin tract infection in 7 patients (3.5%). Varus malunion occurred in 5 patients (2.5%). No implant failure or re-fracture was recorded. Discussion: External fixation of trochanteric fractures is an effective, safe and reliable treatment method. It offers minimal operative and anaesthetic risks, no blood loss, early mobilization and a short hospital stay, with low morbidity and mortality.
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