[Treatment of intertrochanteric femur fractures in high-risk geriatric patients (≥65 years) with external fixation]. / Ileri yasli (≥65 yas) yüksek riskli olgularda gelisen intertrokanterik femur kiriklarinin eksternal fiksatörle tedavisi.

ABSTRACT

BACKGROUND: We evaluated the results of intertrochanteric hip fractures treated with closed reduction and external fixation (minimally invasive and biological osteosynthesis) in patients with high surgical risk. METHODS: Twenty-three patients (14 females, 9 males; mean age 74 [65-88]) with intertrochanteric hip fracture classified as group III and IV according to American Society of Anesthesiologists (ASA) criteria were treated with closed reduction and unilateral external fixation under short-term anesthesia. Fourteen fractures were stable (60.8%) and nine were unstable (39.2%). The mean follow-up was 23.8 months (4-58). We evaluated the operation time, hospitalization time, union time, mobilization capacity, complications, and mortality rates. RESULTS: The mean duration of operation was 25 minutes (15-40), mean duration of hospital stay 4 days (2-9) and average union time 13 weeks. Five patients (21.7%) died due to additional health problems in the first six months after surgery. Superficial pin tract infection occurred in 11 cases (47.8%). There was no implant failure. In the last follow up, an average 5° varus (range 0-8°) and 1 cm shortening (range 0-3) in stable fractures and an average 15° varus (range 8-20°) and 3 cm shortening (range 2-5) in unstable fractures were determined. CONCLUSION: The treatment of intertrochanteric hip fractures with closed reduction and external fixation is an easy, effective and safe biological fixation method with minimal damage to surrounding tissues, especially in patients with high surgical risk.