Objective:
To assess the effectiveness of fixation of intertrochanteric fracture in geriatric high risk patients by Ilizarov fixator.
Background:
Internal fixation of intertrochanteric fractures in patients with anaesthetic or surgical risks has high complication rate, so
external fixation should be considered as a semiconservative method to reduce operative time and complications.
Patients and methods:
Forty elderly high risk patients with intertrochanteric fracture were treated by Ilizarov fixator. All patients had
uncontrolled concomitant medical disorders as hypertension, cardiac disease, diabetes mellitus and chronic hepatic or renal failure.
Results:
All patients were evaluated clinically & radiologically from 5 months to 12 months except 2 patients , one died 3 months post
operative and the other lost follow up 3.5 month post operative after fixator removal. Excellent and good (satisfactory) results were found in
32 patients and fair and poor (unsatisfactory) results were found in 8 patients. The time of radiological union and fixator removal ranged from
10 weeks to 16 weeks. Pin tract infection occurred in all patients. Varus malalignment occurred in 20% of patients. Shortening ranged from 0
to 3 cm in 5 patients.
Conclusion:
the study proved that external fixation of intertrochanteric fractures in elderly high risk patients is a reliable, effective and
safe treatment option. It offers a minimal operative risk, no blood loss, short hospital stay, early mobilization and low morbidity and mortality.