A Current Concept Review for the Use of External Fixators in Elderly Patients with Intertrochanteric Fracture
-
Alireza Moharrami
,
Mir Mansour Moazen Jamshidi
,
Soroush Alaeddini
,
Mazaher Ebrahimian
,
Amir Reza Mafi
Abstract
Intertrochanteric (IT) fractures are responsible for almost half of the fractures in the elderly. The financial burdens of IT fractures are considerable, not only because of their influence on morbidity and mortality but also because they might lead to functional limitation, alleviated quality of life, and a limited possibility to work. There are several methods of fixations for IT fractures, such as cephalomedullary nailing, dynamic hip screw (DHS), proximal femur plate, and external fixator. Most of the patients with this fracture were unsuitable for anesthesia and surgical procedure. The external fixator is a fast, non-invasive, and bloodless method for fixation which would be performed with light sedation. In the present study, we reviewed recent literature regarding external fixators for IT fractures.
1. Sharma A, Sethi A, Sharma S. Treatment of stable intertrochanteric fractures of the femur with proximal femoral nail versus dynamic hip screw: A comparative study.
Rev Bras Ortop. 2018;53(4):477-81. doi: 10.1016/j.rboe.2017.07.008. [PubMed: 30027082]. [PubMed Central: PMC6052185].
2. Tomak Y, Kocaoglu M, Piskin A, Yildiz C, Gulman B, Tomak L. Treatment of intertrochanteric fractures in geriatric patients with a modified external fixator. Injury. 2005;36(5):635-43. doi: 10.1016/j.injury.2004.10.013. [PubMed: 15826624].
3. Chang SM, Hou ZY, Hu SJ, Du SC. Intertrochanteric femur fracture treatment in Asia: What we know and what the world can learn. Orthop Clin North Am. 2020;51(2):189-205. doi: 10.1016/j.ocl.2019.11.011. [PubMed: 32138857].
4. Yang Y, Lin X. Epidemiological features of 877 cases with hip fraction. Zhonghua Liu Xing Bing Xue Za Zhi. 2014;35(4):446-8. [In Chinese]. [PubMed: 25009039].
5. Jensen JS. Classification of trochanteric fractures. Acta Orthop Scand. 1980;51(5):803-10. doi: 10.3109/17453678008990877. [PubMed: 7468173].
6. Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF. Fracture and dislocation classification compendium-2018. J Orthop Trauma. 2018;32(Suppl 1):S1-S170. doi: 10.1097/BOT.0000000000001063. [PubMed: 29256945].
7. Kani KK, Porrino JA, Mulcahy H, Chew FS. Fragility fractures of the proximal femur: Review and update for radiologists. Skeletal Radiol. 2019;48(1):29-45. doi: 10.1007/s00256-018-3008-3. [PubMed: 29959502].
8. Hoseini Zare N, Moharrami A, Mortazavi SMJ. The importance of the lateral femoral wall thickness in intertrochanteric fracture: Educational corner. J Orthop Spine Trauma. 2020;6(1):14-5. doi: 10.18502/jost.v6i1.4536.
9. Wang F, Meng C, Cao XB, Chen Q, Xu XF, Chen Q. Hemiarthroplasty for the treatment of complicated femoral intertrochanteric fracture in elderly patients. Zhongguo Gu Shang. 2018;31(9):818-23. [In Chinese]. doi: 10.3969/j.issn.1003-0034.2018.09.008. [PubMed: 30332874].
10. Khoori M, Moharrami A, Hoseini Zare N, Mortazavi SJ. The importance of length of the cephalomedullary nails for fixation of the proximal femoral fractures: An educational corner. J Orthop Spine Trauma. 2021;6(3):55-6. doi: 10.18502/jost.v6i3.4963.
11. Salehi M, Moharrami A, Hoseini Zare N, Moazen Jamshidi MM, Mortazavi SJ. Choosing device in intertrochanteric fracture based on AO/OTA classification: Educational corner. J Orthop Spine Trauma. 2022;8(1):27-30. doi: 10.18502/jost.v8i1.9042.
12. Moradi A, Moradi M, Emadzadeh M, Bagheri F. Comparison of the dynamic hip screw with the dynamic hip external fixator for intertrochanteric fractures: Report of a randomized controlled trial. Arch Bone Jt Surg. 2021;9(6):665-76. doi: 10.22038/ABJS.2021.53705.2672. [PubMed: 35106332]. [PubMed Central: PMC8765197].
13. Kazemian GH, Emami M, Manafi A, Najafi F, Najafi MA. External fixation vs. skeletal traction for treatment of intertrochanteric fractures in the elderly. Trauma Mon. 2016;21(1):e15477. doi: 10.5812/traumamon.15477. [PubMed: 27218039]. [PubMed Central: PMC4869414].
14. Vossinakis IC, Badras LS. The external fixator compared with the sliding hip screw for pertrochanteric fractures of the femur. J Bone Joint Surg Br. 2002;84(1):23-9. doi: 10.1302/0301-620x.84b1.12034. [PubMed: 11837827].
15. Yousry AH, Chotai PN, El Ghazaly SA, Fayyad TA, Abdelgawad AA. Outcomes of trochanteric external fixation for geriatric inter-trochanteric hip fractures. J Orthop. 2015;12(4):174-8. doi: 10.1016/j.jor.2015.05.019. [PubMed: 26566315]. [PubMed Central: PMC4602004].
16. Vossinakis IC, Badras LS. Management of pertrochanteric fractures in high-risk patients with an external fixation. Int Orthop. 2001;25(4):219-22. doi: 10.1007/s002640100238. [PubMed: 11561494]. [PubMed Central: PMC3620822].
17. Moazen Jamshidi MM, Moharrami A, Tabatabaei Irani P, Ghasemi MA, Mafi AR, Mortazavi SJ. Intrapelvic migration of dynamic hip screw postoperatively leading to total hip arthroplasty: A case report. J Orthop Spine Trauma. 2022;8(2):69-71. doi: 10.18502/jost.v8i2.9316.
Rev Bras Ortop. 2018;53(4):477-81. doi: 10.1016/j.rboe.2017.07.008. [PubMed: 30027082]. [PubMed Central: PMC6052185].
2. Tomak Y, Kocaoglu M, Piskin A, Yildiz C, Gulman B, Tomak L. Treatment of intertrochanteric fractures in geriatric patients with a modified external fixator. Injury. 2005;36(5):635-43. doi: 10.1016/j.injury.2004.10.013. [PubMed: 15826624].
3. Chang SM, Hou ZY, Hu SJ, Du SC. Intertrochanteric femur fracture treatment in Asia: What we know and what the world can learn. Orthop Clin North Am. 2020;51(2):189-205. doi: 10.1016/j.ocl.2019.11.011. [PubMed: 32138857].
4. Yang Y, Lin X. Epidemiological features of 877 cases with hip fraction. Zhonghua Liu Xing Bing Xue Za Zhi. 2014;35(4):446-8. [In Chinese]. [PubMed: 25009039].
5. Jensen JS. Classification of trochanteric fractures. Acta Orthop Scand. 1980;51(5):803-10. doi: 10.3109/17453678008990877. [PubMed: 7468173].
6. Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF. Fracture and dislocation classification compendium-2018. J Orthop Trauma. 2018;32(Suppl 1):S1-S170. doi: 10.1097/BOT.0000000000001063. [PubMed: 29256945].
7. Kani KK, Porrino JA, Mulcahy H, Chew FS. Fragility fractures of the proximal femur: Review and update for radiologists. Skeletal Radiol. 2019;48(1):29-45. doi: 10.1007/s00256-018-3008-3. [PubMed: 29959502].
8. Hoseini Zare N, Moharrami A, Mortazavi SMJ. The importance of the lateral femoral wall thickness in intertrochanteric fracture: Educational corner. J Orthop Spine Trauma. 2020;6(1):14-5. doi: 10.18502/jost.v6i1.4536.
9. Wang F, Meng C, Cao XB, Chen Q, Xu XF, Chen Q. Hemiarthroplasty for the treatment of complicated femoral intertrochanteric fracture in elderly patients. Zhongguo Gu Shang. 2018;31(9):818-23. [In Chinese]. doi: 10.3969/j.issn.1003-0034.2018.09.008. [PubMed: 30332874].
10. Khoori M, Moharrami A, Hoseini Zare N, Mortazavi SJ. The importance of length of the cephalomedullary nails for fixation of the proximal femoral fractures: An educational corner. J Orthop Spine Trauma. 2021;6(3):55-6. doi: 10.18502/jost.v6i3.4963.
11. Salehi M, Moharrami A, Hoseini Zare N, Moazen Jamshidi MM, Mortazavi SJ. Choosing device in intertrochanteric fracture based on AO/OTA classification: Educational corner. J Orthop Spine Trauma. 2022;8(1):27-30. doi: 10.18502/jost.v8i1.9042.
12. Moradi A, Moradi M, Emadzadeh M, Bagheri F. Comparison of the dynamic hip screw with the dynamic hip external fixator for intertrochanteric fractures: Report of a randomized controlled trial. Arch Bone Jt Surg. 2021;9(6):665-76. doi: 10.22038/ABJS.2021.53705.2672. [PubMed: 35106332]. [PubMed Central: PMC8765197].
13. Kazemian GH, Emami M, Manafi A, Najafi F, Najafi MA. External fixation vs. skeletal traction for treatment of intertrochanteric fractures in the elderly. Trauma Mon. 2016;21(1):e15477. doi: 10.5812/traumamon.15477. [PubMed: 27218039]. [PubMed Central: PMC4869414].
14. Vossinakis IC, Badras LS. The external fixator compared with the sliding hip screw for pertrochanteric fractures of the femur. J Bone Joint Surg Br. 2002;84(1):23-9. doi: 10.1302/0301-620x.84b1.12034. [PubMed: 11837827].
15. Yousry AH, Chotai PN, El Ghazaly SA, Fayyad TA, Abdelgawad AA. Outcomes of trochanteric external fixation for geriatric inter-trochanteric hip fractures. J Orthop. 2015;12(4):174-8. doi: 10.1016/j.jor.2015.05.019. [PubMed: 26566315]. [PubMed Central: PMC4602004].
16. Vossinakis IC, Badras LS. Management of pertrochanteric fractures in high-risk patients with an external fixation. Int Orthop. 2001;25(4):219-22. doi: 10.1007/s002640100238. [PubMed: 11561494]. [PubMed Central: PMC3620822].
17. Moazen Jamshidi MM, Moharrami A, Tabatabaei Irani P, Ghasemi MA, Mafi AR, Mortazavi SJ. Intrapelvic migration of dynamic hip screw postoperatively leading to total hip arthroplasty: A case report. J Orthop Spine Trauma. 2022;8(2):69-71. doi: 10.18502/jost.v8i2.9316.
| Files | ||
| Issue | Vol 9, No 2 (2023) | |
| Section | Review Article | |
| DOI | https://doi.org/10.18502/jost.v9i2.12622 | |
| Keywords | ||
| External Fixation Intertrochanteric Fracture Hip | ||
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How to Cite
1.
Moharrami A, Moazen Jamshidi MM, Alaeddini S, Ebrahimian M, Mafi AR. A Current Concept Review for the Use of External Fixators in Elderly Patients with Intertrochanteric Fracture. J Orthop Spine Trauma. 2023;9(2):59-61.
