External fixation via the anterior inferior iliac spine for proximal femoral fractures in young patients

Abstract

Background and aim Acute 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 methods Twenty-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. Results The 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. Conclusion Collectively, 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.

Temporary pelvi-femoral external fixation versus skeletal traction for displaced pertrochanteric fractures in the young: a retrospective case control study

“…In PPEF group, an external xator was used to initially stabilize the pertrochanteric fractures in operation room via C-arm when other body injuires received acute surgical treatment, postoperative treatment and clinical evaluation were performed according to our published methods [9]. Moreover, severe orthopaedic trauma such as pelvic fractures and other limb injuries could be initially xed meanwhile.…”

“…We developed a novel protocol of pelvi-femoral external xation (PPEF) via the anterior inferior iliac spine for displaced pertrochanteric femoral fractures in the young [9]. But there is no comparative study to further prove its clinical signi cance and optimize treatment strategy.…”