Outcome of unstable pertrochanteric fractures in high-risk geriatric treated with external fixators

Background: To review the outcome of high-risk geriatrics with unstable pertrochanteric fractures treated with external fixator. Methods: : Eighteen consecutive patients with pertrochanteric fractures were operated with external fixator by using closed reduction technique. AO type (A2.2, A2.3, A3.1, A.3.2 and A.3.3)) fractures were included in the study. Accompanying diseases, operating time, transfused blood units, duration of hospitalization, complications, healing time and mortality were recorded. Patients were followed clinically and radiologically for two years at least. The Harris Hip Score was used to document hip function at each regular follow-up. Results: : Fifteen patients with average age of 71.5 years were available for final evaluation. The mean operating time was 41.1 min and union was achieved in all cases with an average time of 16 weeks. The mean Harris Hip Score at one, three, six, twelve and twenty-four month postoperatively was 42.07 ± 8.55; 55.07 ± 11.62; 70.07 ± 10.32; 86.27 ± 9.06 and 89.27 ± 8.81 respectively. Complications included fifteen of patients undergoing loss of some motion in the knee and four of them had to experience revision surgery because of knee stiffness, ten cases of pin-tract infections, seven cases of deep venous thrombosis, two cases of migration of the screws and two cases limb shortening Conclusions: : It was of paramount importance that a comprehensive, multidisciplinary cooperation was consistently implemented and medical personnel provided detailed rehabilitation training plan and kept close contact with patients to make these high-risk geriatrics with unstable perotrochanteric fractures achieve satisfactory long-term effect owing to short-term functional results are quite unsatisfactory.