Functional outcome of external fixation of intertrochanteric femur fractures in elderly patients

Background: Intertrochanteric fractures are a prevalent occurrence in the elderly following accidents, and they are extracapsular fractures of the proximal femur at the level of the greater and lesser trochanters. For elderly patients with external fixation and a high anaesthetic risk, the treatment of this femoral fracture is a minimally invasive, safe, and rapid procedure. Objective: Assess the efficacy of external fixation devices in the treatment of closed intertrochanteric femur fractures in aged patients associated with a high risk of anaesthesia. Methods: Between April 2014 and July 2017, the Department of Orthopaedic Surgery at Al-Kadhemia Teaching Hospital conducted a study that analysed 30 cases of intertrochanteric fractures with a high risk of anaesthesia. The patients, who were aged 65 to 85 years, included 18 women and 12 males, with 11 right-sided fractures and 19 left-sided fractures. Under general anaesthesia (8 cases), neuraxial anaesthesia (15 cases), epidural anaesthesia (5 cases), and local anaesthesia (2 cases), all fractures were stabilised with an external fixator. Results: The operation was completed in an average of 35 minutes (range: 25-50 minutes), and no blood transfusion was necessary. After four months, the remaining 28 patients did not succumb to death. The Judet functional score indicated that the majority of patients achieved satisfactory and exceptional outcomes. Pin tract infection and deep vein thrombosis were the most prevalent complications. Blood loss, operation time, postoperative pain, and hospital stay are all substantially reduced by the use of an external fixator, which precludes the necessity for surgical incisions other than the slotted incision for pin insertion. Conclusion: External fixation of intertrochanteric fractures is a minimally invasive, safe, and expeditious procedure that is associated with minimal preoperative and postoperative complications for elderly patients with a high anaesthetic risk.