Role of external fixator in the management of trochanteric fractures of the femur - damage control orthopaedics

ABSTRACT

To compare the Modified AO fixator [MAO] with sliding hip screw [SHS] in the treatment of trochanteric fractures. 68 patients of both genders presenting with trochanteric fractures at Combined Military Hospital Lahore. This was a Prospective, Randomized Study. This study was conducted at the in patient surgical Unit at Combined Military Hospital Lahore from 1st June 2006 till 30 November 2007. 68 high risk patients of ASA-IVa-c with a trochanteric fracture were selected. The mean age was 73 yrs +/- . There were 17[28%] males and 45 [72%] females. There was no delay between injury and operation when treated by external fixation [mean 3.13 days, 1 to 7]. All fractures in group I united clinically and radiologically at 24 weeks. The surgery required lesser time [mean 29.35 minutes, 20 to 45], the blood loss was minimal [mean= 33.33 ml] and required a short hospital stay [mean of 3.96 days, range 2 to 7 days] as compared to the group II. At the final follow-up, 03 [8%] patients had shortening or malrotation, 02[03%] patients had varus angulation, implant failure [pin breakage] in one patient [1.4%] and pin cut out was observed in one [1.4%]. Our results confirm that the Modified AO fixator is an effective device for treating pertrochanteric fractures and is a useful alternative to conventional fixation with the sliding hip screw