Orthofix Pertrochanteric Fixator: A Better Treatment for Intertrochanteric Fractures in High-Risk Elderly Patients

Abstract Background Although the Proximal Femoral Nail Antirotation (PFNA) is currently considered to be one of the preferred treatment methods for intertrochanteric fractures. the external fixation method can provide similar clinical results. The external fixation is also more minimally invasive such as Orthofix Pertrochanteric Fixator (OPF). We expect that the use of the Orthofix Pertrochanteric Fixator (OPF) will reduce the incidence of complications. We have applied a clinical trial to compare the effectiveness and the Complications of the two surgical methods for in the elderly patients with intertrochanteric fractures. Methods 243 elderly patients with high-risk comorbidities were diagnosed as intertrochanteric fractures, which attributed to the low energy injuries like sliping and falling down at home. The patients were randomly divided into two groups based on the method of internal fixation. 103 patients in group A were applied with OPF, 140 patients in group B were treated with PFNA. Results The OPF is a reasonable treatment for the elderly patients ,who are co-morbid with other high-risk diseases. No significant difference between the two groups in terms of quality of fracture repositioning and Harris scores(HHS). The PFNA operation time (14.41±2.10) was longer than OPF group (14.41±2.10), (p<0.05). 107 patients in PFNA group got postoperative blood transfusion, but none in OPF group. The average length of staying at hospital in group A and B were (4.10±0.82) days and (5.63±0.83) days. 9 patients with failed PFNA fixations patients got the satisfactory recovery following bed rest. There were 4 deaths in group A, 3 coronary artery disease cases and 1 cerebral infarction cases during hospitalization, and 15 deaths in group B. 9 cases of pin-tract infection occurred in group A. Group A healing time of fractures (14.50±1.09) was longer than group A (12.84±1.17). There is amost no diffifence in postoperative complication between group A and B. Conclusion The OPF is an effective fixation for high-risk elderly patients with intertrochanteric fractures. It is notably simple to perform, with less bleeding, minimal radiation exposure, a much lower complication rate, a shorter hospital stay and satisfactory functional recovery. Evidence level Therapeutic study grade III