Temporary pelvi-femoral external fixation versus skeletal traction for displaced pertrochanteric fractures in the young: a retrospective case control study

Abstract

Abstract Background: Initial treatment of displaced pertrochanteric fractures in the young is extremely different with the elderly for high rate of co-morbidities. Comparing to skeletal traction (ST), temporary pelvic-femoral external fixation (PPEF) via the anterior inferior iliac spine could produce improved outcome. Methods: 46 young polytraumatic patients with displaced pertrochanteric factures (average age 38.0±8.5 years) were included and retrospectively analyzed between January 2015 and December 2018. ST involved in 23 patients, and PPEF involved in 23 patients as the initial treatment options when other body injuries were treated surgically. Definite treatment was performed when patients’ general conditions permitted. General characteristics, surgical data and functional outcome were recorded and compared grouply statistically. Results: The PPEF group was identified to have more reduced visual analog scales(3.7±0.3 vs. 2.0±0.9), greater fracture reduction degrees(13.5±6.9 vs. 6.5±3.0), less definitive surgical time(45.1±6.6 min vs. 52.7±8.5 min), less varus angulation>5°（2 vs. 3），less limb shortening (0.5±0.2 vs. 0.7±0.3), and high percentage of excellent Harris Hip scores (73.9% vs. 30.4%) than the ST group. Although the latter had less initial surgical time, no blood loss, and unsignificant time interval to definite surgery, hospital days, bedsores, healing time, deaths. Conclusion: PPEF via the anterior inferior iliac spine is proved to be an optimal temporary treatment protocol for displaced pertrochanteric fractures in the young polytraumatic patients.