title: Proximal screws placement in intertrochanteric fractures treated with external fixation: comparison of two different techniques.
abstract: BACKGROUND
  To compare two different techniques of proximal pin placement for the treatment of intertrochanteric fractures in elderly patients utilizing the Orthofix Pertrochanteric Fixator.
  
  
  METHODS
  Seventy elderly high-risk patients with an average age of 81 years were treated surgically for intertrochanteric fracture, resulting from a low energy trauma. Patients were randomly divided in two groups regarding to the proximal pin placement technique. In Group A the proximal pins were inserted in a convergent way, while in Group B were inserted in parallel.
  
  
  RESULTS
  All fractures healed uneventfully after a mean time of 98 days. The fixator was well accepted and no patient had significant difficulties while sitting or lying. The mean VAS score was 5.4 in group A and 5.7 in group B. At 12 months after surgery, in group A the average Harris Hip Score and the Palmer and Parker mobility score was 67 and 5.8, respectively. In group B, the average Harris Hip Score and the Palmer and Parker mobility score was 62 and 5.6, respectively. No statistically significant difference was found regarding the functional outcome. The mean radiographic exposure during pin insertion in Group A and Group B was 15 and 6 seconds, respectively. The difference between the two groups, regarding the radiographic exposure, was found to be significant.
  
  
  CONCLUSIONS
  Proximal screw placement in a parallel way is simple, with significant less radiation exposure and shorter intraoperative duration. In addition, fixation stability is equal compared to convergent pin placement.
authors.affiliation: Department of Orthopaedic Surgery, University of Ioannina School of Medicine, Ioannina, Greece. vekrismd@otenet.gr
authors.forename: Marios D
authors.initials: MD
authors.lastname: Vekris
authors.forename: Marios G
authors.initials: MG
authors.lastname: Lykissas
authors.forename: Gregory
authors.initials: G
authors.lastname: Manoudis
authors.forename: Alexandros N
authors.initials: AN
authors.lastname: Mavrodontidis
authors.forename: Christos D
authors.initials: CD
authors.lastname: Papageorgiou
authors.forename: Anastasios V
authors.initials: AV
authors.lastname: Korompilias
authors.forename: Ioannis P
authors.initials: IP
authors.lastname: Kostas-Agnantis
authors.forename: Alexandros E
authors.initials: AE
authors.lastname: Beris
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D001863:Bone Screws; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006620:Hip Fractures / Q000503:physiopathology / Q000601:surgery*; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome