[Fixation of trochanteric or subtrochanteric fractures using dynamic external fixators]

We present a fixation system for trochanteric or subtrochjanteric fractures using a dynamic external fixator. The Citieffe/CH-N fixator was proposed for elderly patients with a significant operative risk (ASA III or IV). A long dynamic screw measuring 9 mm in diameter is inserted into the neck and the head of the femur on a guide wire through a tube protecting skin and muscles. This long screw is connected to the body of the fixator to enable impaction at the fracture level if compression is needed. The dynamic screw can be released to allow free gliding to achieve a dynamic fixation of the fracture. Distraction with the fixator can also be used for subtrochanteric unstable fractures to correct a varus deformity. This technique is a simple rapid solution with minimal operative risk. Complications are minimal and generally temporary, e.g. pin tract infections.