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The external fixator compared with the sliding hip screw for pertrochanteric fractures of the femur

Weston General Hospital, Grange Road, Uphill, Weston-super-Mare, Somerset BS23 4TQ, UK.

L. S. Badras, PhD, Head

Department of Orthopaedic Surgery, Volos General Hospital, 134 Polymeri Street, 382 21 Volos, Greece.

Correspondence should be sent to Mr I. C. Vossinakis at 58 Ferndene, Bradley Stoke, Bristol BS32 9DF, UK.

In a prospective, randomised study we have compared the pertrochanteric external fixator (PF) with the sliding hip screw (SHS) in 100 consecutive patients who were allocated randomly to the two methods of treatment. Details of the patients and the patterns of fracture were similar in both groups. Follow-up was for six months.

Use of the PF was associated with significantly less blood loss, a shorter operating time, reduced postoperative pain, shorter hospitalisation (p < 0.001), earlier mobilisation (p < 0.001) and a reduced rate of mechanical complications (p < 0.01). Superficial infection was significantly more common with the PF (p < 0.01), but without long-term adverse consequences. There were no differences in the healing of the fracture, mortality or final functional outcome. Our results indicate that the external fixator is an effective and safe device for treating pertrochanteric fractures and should be considered as a useful alternative to conventional fixation with the sliding hip screw.

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