Abstract
Background and aimAcute treatment of young patients with proximal femoral fracture (PFF) remains a challenge for trauma surgeons due to major fracture displacement and heavy pain in clinical practice. Traditional methods have a variety of intrinsic defaults and cannot successfully manage the requirements of young patients. Benefiting from our anatomic research, we explored a new method of external fixation for this specific trauma and evaluated its feasibility and clinical outcomes.Material and methodsTwenty-three young multiple-trauma patients with PFF were included in this study. Surgical treatment was applied using an external fixator via the anterior inferior iliac spine (AIIS). Electronic patient records, surgical characteristics, clinical outcomes, and complications were reviewed for each patient.ResultsThe mean surgical time was 30.3 ± 7.3 min. The mean blood loss was 25.3 ± 10.8 mL. No iatrogenic nerve palsy, pin tract infection, failure of external fixation, or bedsores were observed. The postoperative visual analog scale score was significantly lower than the preoperative score (P < 0.01). The mean fracture reduction rate of the femur was 58.1 ± 17.0%, and the mean degree of reduction was 13.5 ± 6.9°. The mean external fixation time was 7.6 ± 4.0 days and intramedullary nailing was performed. The mean hospital, follow-up, and healing times were 28.7 ± 8.7 days, 23.5 ± 7.9 months, and 22.8 ± 5.7 weeks, respectively. The Harris Hip Score indicated excellent or good results in 20 patients.ConclusionCollectively, the results of this study revealed that external fixation via the AIIS is a safe, rapid, and effective method for acute treatment of PFF in young patients.
Highlights
Collectively, the results of this study revealed that external fixation via the anterior inferior iliac spine (AIIS) is a safe, rapid, and effective method for acute treatment of proximal femoral fracture (PFF) in young patients
Proximal femoral fractures (PFFs) in young patients are the result of high energy impact and often associated with major fracture displacement and heavy pain
Acute treatment of PFFs involves lower-limb skin or skeletal traction [3,4,5], and intramedullary nailing is considered to be the definitive treatment in the majority of trauma patients [6,7,8,9,10]
Summary
Proximal femoral fractures (PFFs) in young patients are the result of high energy impact and often associated with major fracture displacement and heavy pain. Acute treatment of these specific fractures remains a challenge for trauma surgeons due to multisystem injuries and poor conditions during emergencies [1,2]. Acute treatment of PFFs involves lower-limb skin or skeletal traction [3,4,5], and intramedullary nailing is considered to be the definitive treatment in the majority of trauma patients [6,7,8,9,10]. With advances in implant material, surgical techniques, and anatomic research, and popularization of the concept of enhanced recovery after
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