Treatment of intertrochanteric fracture femur by Ilizarov fixator in elderly patients

Abstract

Objective To assess the effectiveness of fixation of intertrochanteric fracture femur in elderly high-risk patients using Ilizarov fixator. Background Internal fixation of intertrochanteric fractures is a routine procedure, but in patients with anesthetic risks, external fixation can be considered a semiconservative method to reduce operative time and complications. In this study, the functional and radiological results of management of intertrochanteric fracture femur in elderly patients using Ilizarov fixator is evaluated. Patients and methods A total of 20 elderly high-risk patients with intertrochanteric fracture were treated by Ilizarov fixator. All patients had uncontrolled concomitant medical disorders such as hypertension, diabetes mellitus, and chronic hepatic or renal failure. The age range was 50–85 years. Results The patients were followed up for a mean of 7.5 months with a range from 6 to 9 months. Excellent and good (satisfactory) results were found in 16 patients and fair and poor (unsatisfactory) results were found in four patients. The time of radiological union and fixator removal ranged from 10 to 16 weeks. Pin-tract infection occurred in all patients. Varus malalignment occurred in 20% of patients. Shortening ranged from 0 to 3°. There were two cases of penetration of the femoral head. Conclusion It was found that external fixation of intertrochanteric fractures in elderly high-risk patients is a reliable, effective, and safe treatment option. It offers minimal operative risk, no blood loss, early mobilization, short hospital stay, and low morbidity and mortality.