Outcome of external fixation for intertrochanteric neck femur fracture in high risk elderly patients

Abstract

Intertrochanteric neck femur fractures are the most severe of all fragility fractures. In this prospective study, Between oct 2016 and nov 2018, 30 elderly patients within inclusion criterion were treated using stainless steel uniplanar external fixator by same surgeon with similar protocol for every case. These patients followed up for 1 year subsequently. The present study was conducted using the minimally invasive technique of external fixation for the management of intertrochanteric fracture in high risk elderly patients. In our study 88 percent of the cases were above 60 years. Our study involved 60% of female cases indicating that this fracture is more common in females due to osteoporosis in Indian population. Our study involved stable type of fracture more commonly. 72% of cases were of EVANS stable type. In conclusion, as life span of people increases incidence of intertrochanteric fracture increases in elderly patients. Open reduction and internal fixation of intertrochanterc fractures is a treatment 'gold standard', but the morbidity and mortality rates are high in elderly patients with significant co-morbid factors. Nonoperative treatment involves prolonged immobilization and hospitalization, With many concomitant problems and high mortality obtaining a perfect reduction of the intertrochanteric fracture may not be the main objective for this high-risk group but to operate with the least blood loss in the shortest time and an anaesthetic technique of low risk, which ultimately facilitates early mobilization in the postoperative. In our study we shows that Closed reduction and external fixation is an alternative procedure, which minimizes these complications.