Evaluation of External Fixation Results in High-risk Older Patients with Intertrochanteric Femur Fractures

Abstract

Background: Intertrochanteric femur fractures are common in older people. In high-risk patients, especially American Society of Anesthesiologists (ASA) scores 3 and 4, surgery with internal fixation can cause excessive stresses. Therefore, external fixation is another option for treating these patients. Objective: To evaluate the results and complications of external fixation in elderly patients with intertrochanteric fractures. Methods: Twenty-six surgically high-risk patients with intertrochanteric fractures admitted to our clinic were treated with external fixation (January 2010- November 2011). Epidemiological and radiological data and also complications were recorded at each follow-up. Results: No complications occurred in 13 patients. The remaining 13 patients had complications after surgery: Of the patients, 10 had implant failure (6 pin migration and 4 pin cut-out) and 3 had pin tract infections. Six patients who had implant failure (2 pin migration and 4 pin cut-out) underwent revision. Unrevised complicated patients (4 pin migration) and 2 of 3 patients with pin tract infections had malunion and shortening. High risk older patients with external fixation had a high complication and morbidity rate. Conclusion: We do not recommend using pertrochanteric external fixators in high-risk patients due to the high revision rate and serious complications.