title: Results of a compression pin alongwith trochanteric external fixation in management of high risk elderly intertrochanteric fractures.
abstract: BACKGROUND
  External fixation is a well-known procedure for the management of intertrochanteric fractures in very elderly high-risk patients. A new compression pin that can be adapted to all fixators was designed to provide inter fragmentary compression. In the present study, its effects on the fracture stability and healing were evaluated.
  
  
  METHODS
  Thirty-one patients treated using compression pin and thirty-six patients treated using standard pins were evaluated retrospectively between January 2009 and July 2014. Patients were evaluated according to age, gender, duration of preoperative period, duration of operation time, American Society of Anesthesiologists (ASA) scores, and immediate postoperative and final femoral neck angle measurements. The stability of the fixation was evaluated by calculating the secondary varus angulation after weight bearing.
  
  
  RESULTS
  Thirty one patients (82.1 ± 6.1 years old) comprised the compression pin group, and 36 patients (83.33 ± 6.24 years old) comprised the standard pin group. From the time of weight bearing to healing time, 1.0 ± 1.25° (0-4) and 2.5 ± 1.8° (0-9) of secondary varus angulation in the compression pin and standard pin groups were measured, respectively (P= 0.000). With weight bearing, 2 of 31 (6%) and 9 of 36 (25%) patients in the compression and standard pin groups, respectively, had >4° of secondary varus angulation. In the compression pin group, 13 fractures were unstable, but only 2 (15%) of them had >4° of secondary varus angulation. In the standard pin group, 19 fractures were unstable, and 7 (37%) of them had >4° of secondary varus angulation.
  
  
  CONCLUSIONS
  Treatment of very elderly, high risk patients' with intertrochanteric fractures with external fixation is effective. Compression pin maintained stability better than standard pins after weight bearing, especially for unstable intertrochanteric fractures.
authors.affiliation: Department of Orthopaedics, State Hospital, Malatya, Turkey.
authors.forename: Aydın
authors.initials: A
authors.lastname: Arslan
authors.affiliation: Department of Orthopaedics, Ankara Numune Training and Research Hospital, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Utkan
authors.affiliation: Department of Physical Therapy, State Hospital, Malatya, Turkey.
authors.forename: Tuba Tulay
authors.initials: TT
authors.lastname: Koca
keywords: Compression pin; Geriatric nursing; external fixator; fracture fixation; intertrochanteric fracture; intertrochanteric fractures; osteoporotic fractures; stability