External fixation in the Treatment of Intertrochentric Fractures in Elderly Patients

Abstract

Objective: To evaluate the results of external fixation for intertrochentric hip fractures in elderly patients with high anesthetic risk.Patients and methods: Prospective study conducted at Department of Orthopedic surgery in Al-Kadhemia Teaching Hospital from January 2007 to October 2013 to evaluate 31 patients, with intertrochentric fracture and high risk for anesthesia, 19 females and 12 males, age between (47 – 90) years. All fractures were stabilized with external fixator under spinal, epidural, general and even local anesthesia.Results: The average time of operation was 35 minutes (25-50), no one needs blood transfusion.No mortality in immediate post operative period .but three died after 10 days of operation because of co morbid disease. Bony union is obtained in the rest of patients, in 16 weeks, most patients had excellent and good results according to judget functional score, Pin tract infection and Deep vein thrombosis is the commonest complication.The use of external fixator was associated with significant less blood loss, shorter operative time, reduction in post operative pain, shorter hospitalization.Conclusion: External fixation in elderly patients with high anesthesia risk is fast, minimally invasive procedure in the treatment of intertrochentric fracture, resulting in fewer pre and post operative complication.