Postponed Fracture of Femur Treated by Novel "Fixation in situ" Approach with Ilizarov: A Case Report

The term "Postponed Fractures" (PF) appears to be more logical when one talks about neglected fractures. The "Fixation in situ" (FIS) approach with Ilizarov is a novel concept to treat such case. A 35-year male with comminuted subtrochanteric fracture with a big butterfly fragment (left femur) reported after 3 weeks of injury. He was ready for surgery at 6 weeks of injury with 5 cm shortening and external rotation deformity. Apprehending that Open surgery at that time would invite extensive soft tissue dissection resulting in infection, "Fixation in situ" approach was contemplated. A Hybrid Ilizarov Femoral frame was mounted without disturbing the fracture. Corticotomy through distal metaphysis was done to correct rotation and shortening. Accordion manoeuvre (AM) was also applied. The apparatus was removed at 6 months. He regained length, rotation and full function.