Treatment of intertrochanteric femoral fractures with the use of a modular axial fixator device

Objectives: Intertrochanteric femoral fractures are usually encountered in the elderly, leading to morbidity and even mortality due to age-related systemic complications. In this study, we evaluated the use of a modular axial fixator device in the treatment of intertrochanteric femoral fractures. Methods: Intertrochanteric femoral fractures of 25 patients (18 females, 7 males; mean age 70 years; range 18 to 91 years) were treated by the use of a modular axial fixator. The fractures were classified according to the Boyd-Griffin classification. Surgery was performed after a mean of 5.76 days following trauma. The patients were allowed to walk using crutches on the second postoperative day and a single crutch after sufficient callus formation was radiologically determined. Final evaluations were made by the Foster’s classification. The mean follow-up was 12 months (range 6 to 24 months). Results: The mean operation duration was 34 minutes. Union was achieved in all patients after a mean of 12.3 weeks (range 9 to 18 weeks). Three patients (12%) developed varus deformity of 3, 5, and 9 degrees, respectively. Shortening in a range of 1 cm to 1.5 cm was detected in three patients (12%). Postoperatively, 10 patients developed pin tract infections, none of which required revision or removal of the fixator. Final evaluations yielded excellent and good anatomical results in 72% and 28%, and functional results in 80% and 20%, respectively. Conclusion: Reducing both the operation time and the immobilization period is of vital importance particularly in elderly patients with intertrochanteric femoral fractures. Due to its short length, the modular axial fixator offers significant advantages including higher tolerability, rapid weight bearing allowance, and achievement of union without seriously complicating events.