Management of Complex Subtrochanteric Fractures by a Dynamic External Fixator

This work introduces a dynamic external fixator or used in the treatment of complex subtrochanteric fractures in which the traditional surface or intramedullary fixation methods would be deemed difficult or associated with a higher morbidity.The current study included 19 patients. These 19 fractures were classified according to Seinsheimer classification as follows; nine patients were type V, five patients were type IV, three type lib and two type Ila fractures). Three patients were open gunshot injuries and sixteen were closed. All patients included in this prospective study were males and sustained high energy trauma. They all were treated using the dynamic external fixator after performing an indirect fluoros- copy-controlled reduction.Fixator removal was achieved at an average period of 6.5 months (range; 4.5 to 9 months). Pre-injury activity level was restored in 16 and Harris Hip Score averaged 81% after removal of the external fixator.Dynamic external fixation can be considered as a reliable method of fixation for complex subtrochanteric fractures. The time till union of the fractures is comparable to that attained by internal fixation methods; moreover, it offers the advantage of being minimally invasive.