External Fixation Versus Hemiartroplasty In Unstable Intertrochanteric Hip Fractures Of The Elderly

Area of Science:

• Orthopaedic Surgery
• Traumatology

Background:

• Unstable intertrochanteric hip fractures present a significant challenge in elderly patients.
• Current treatment options include external fixation (EF) and hemiarthroplasty (HA), each with potential benefits and drawbacks.

Purpose of the Study:

• To compare the efficacy and outcomes of external fixation (EF) versus hemiarthroplasty (HA) in elderly patients with unstable intertrochanteric hip fractures.
• To evaluate surgical time, hospital stay, functional scores, and mortality rates between the two treatment groups.

Main Methods:

• A retrospective study included 42 elderly patients with Orthopaedic Trauma Association type 31A2-2 or 31A2-3 fractures.
• Twenty patients were treated with external fixation (EF) and 22 patients with hemiarthroplasty (HA).

Main Results:

• The mean operative room time was significantly shorter for EF (45 minutes) compared to HA (108 minutes) (p<0.05).
• The mean postoperative hospital stay was shorter for EF (2.7 days) than for HA (4.9 days) (p<0.05).
• No significant differences were observed in total length of hospital stay, functional scores, or mortality rates between the EF and HA groups.

Conclusions:

• External fixation (EF) may serve as a valuable, less invasive, and more cost-effective alternative to hemiarthroplasty (HA) for carefully selected elderly patients with unstable intertrochanteric hip fractures.
• EF, when applied with adequate stability, offers comparable functional outcomes and mortality rates to HA.