Treatment of intertrochanteric fractures in geriatric patients with a modified external fixator

Tomak, Yılmaz; Kocaoğlu, Mehmet; Pişkin, Ahmet; Yıldız, Cemil; Gulman, Birol; Tomak, Leman

doi:10.1016/j.injury.2004.10.013

Cited by 27 publications

(33 citation statements)

References 17 publications

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“…As with other studies ( 4,7,10,13,17) the most common complications in the present study was pin tract infections, whether superficial or deep respond well to treatment.…”

Section: Discussionsupporting

confidence: 87%

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Treatment of intertrochanteric fractures of the femur with external fixation

Thamer¹

2017

Int. J. Adv. Res. Biol. Sci.

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“…As with other studies ( 4,7,10,13,17) the most common complications in the present study was pin tract infections, whether superficial or deep respond well to treatment.…”

Section: Discussionsupporting

confidence: 87%

“…Previous reports on external fixations showed short operating and hospitalization time, high fracture union rate and minimum blood loss 6,7,17,18 .…”

Section: Discussionmentioning

confidence: 97%

Treatment of intertrochanteric fractures of the femur with external fixation

Thamer¹

2017

Int. J. Adv. Res. Biol. Sci.

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“…A surgical procedure that has minimal surgical blood loss, short operating time and hospital stay, minimal anaesthetic risks, least morbidity and mortality rate and early weight bearing is favoured. 19 External fixators can be considered as a semi conservative method. 20 External fixation gives a stable fixation, allows early mobilization thus preventing the complications of prolonged recumbence.…”

Section: Discussionmentioning

confidence: 99%

External Fixation of Intertrochanteric Fractures as an Option in High Risk Geriatric Patients

Badoo¹,

Bashir²,

Shah³

et al. 2015

jemds

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OBJECTIVE:The purpose of this study is to evaluate the usefulness of external fixation of intertrochanteric fractures in high risk geriatric patients. DESIGN: Prospective clinical study. SETTINGS: Level-1 trauma Centre. PATIENTS: Fifty high risk geriatric patients with intertrochanteric fractures. INTERVENTION: Close reduction and external fixation using AO external fixator. OUTCOME MEASURED: fracture union, time to union, pin tract infection rate, shortening, varus collapse and range of motion at knee. RESULTS: Fifty patients with average age of 68.5 years all high anaesthetic/surgical risk were managed by closed reduction and external fixation. Forty were operated under regional and ten under local anaesthesia. Eight patients died before fracture union and four were lost in follow up after removal of fixator. Remaining thirty eight were in regular follow up for at least six months. Pin tract inflammation was the most common complication while shortening and varus collapse occurred in ten cases. CONCLUSION: external fixation of intertrochanteric fractures is useful in high risk geriatric patients. KEYWORDS: intertrochanteric fractures, external fixation. INTRODUCTION:Hip fractures are a leading cause of death and disability among the elderly. 1 These fractures include femoral neck and intertrochanteric fractures. Intertrochanteric fractures generally occur as a result of low energy trauma in advanced age, whereas they are caused by high energy trauma in young age. 2 The incidence of intertrochanteric fractures is increasing day by day as is the life expectancy. Life time risk in industrialized countries of intertrochanteric fractures is 6% for men and 18% for women. 3 Thus we have old patients, many of them with co morbidities, having intertrochanteric fractures. Treatment goals in this population include early rehabilitation, restoration of the anatomic alignment of the proximal part of the femur and maintenance of the fracture reduction. 4 Various treatment methods used for intertrochanteric fractures include operative and nonoperative. 5 Historically, non-operative management took one of the two different protocols. In first approach, directed at early mobilization within the limits of the patient discomfort, the patient is allowed out of bed and in chair within a few days of injury. Ambulation was delayed, but the early bed to chair mobilization helped prevent many complications of prolonged recumbence. This approach did not attempt to treat the fracture specifically and accepted the deformity that invariably ensues. The second approach, in contrast, attempted to establish and maintain a reasonable reduction via skeletal traction (Hamilton Russel traction) until fracture union occurred. This technique was prolonged with difficulty in maintaining the reduction; further all the complications of prolonged recumbence like pressure sores, urinary tract infection, deep vein thrombosis, pulmonary embolism, chest infection are there. Operative methods include open reduction and internal fixation by sli...

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“…19 External fixators can be considered as a semi conservative method. 20 External fixation gives a stable fixation, allows early mobilization thus preventing the complications of prolonged recumbence. External fixation is usually done under spinal/ epidural anaesthesia.…”

Section: External Fixation Of Intertrochanteric Fractures In High Rismentioning

confidence: 99%

“…In such patients conservative method by traction (Hamilton Russel traction) is an option. It has very high rates of 1,3,7,9,16,18,20 . Authors have been using external fixators for managing intertrochanteric fractures for many years with good results 10 .…”

Section: Introductionmentioning

confidence: 99%