Role of External Fixator in the Management of Trochanteric Fractures of the Femur – Damage Control Orthopaedics

Abstract

Objectives: To compare the Modified AO fixator (MAO) with sliding hip screw (SHS) in the treatment of 
trochanteric fractures. 
Data Source: 68 patients of both genders presenting with trochanteric fractures at Combined Military Hospital 
Lahore.  
Study Design: This was a Prospective, Randomised Study. 
Place and Duration of Study: This study was conducted at the in patient surgical Unit at Combined Military 
Hospital Lahore from 1st June 2006 till 30 November 2007.  
Materials and Methods: 68 high risk patients of ASA-IVa-c with a trochanteric fracture were selected.  
Results: 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= 33.33ml) 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%).  
Conclusion: 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.