الفهرس 
Etiopathology of hip fracturesOnly 14 pages are availabe for public view
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Abstract
Many orthopaedic surgeons confine the use of the Ilizarov external fixator as a definitive treatment modality to open fractures and to those cases with bad skin condition.
Admitting that this is a perfectly true indication for the use of external fixation, the current study shows that the advantages of using the Ilizarov external fixator in treating fractures such as subtrochanteric fractures of the femur over conventional internal fixation options may be extended to more than these limited conditions.
Shorter operative time, negligible blood loss, together with definitive stable fixation, makes the Ilizarov device a perfect choice for poly-traumatized patients as a damage control procedure.
Early ambulation and range of motion exercises are of utmost importance for decreasing the risk of joint stiffness, deep venous thrombosis, pulmonary embolism, chest and urinary tract infection, bed sores and osteoporosis.
Elderly patients and those with medical comorbidities can benefit most from the early ambulation that the Ilizarov fixator provides, avoiding all the previously mentioned complications of prolonged recumbence.
Early return to work and preserving hip and knee range of motion when using the Ilizarov fixator is vital for younger age group patients to regain their pre-fracture activities and ability to work and provide for themselves and their families decreasing a load off the community.
The overall cost of using the Ilizarov device and principles in the management of comminuted subtrochanteric fractures is much reduced, compared to the other conventional internal fixation options. That is because complications such as fixation failure and implant failure are very common when using conventional internal fixation devices in this type of fracture and need surgical intervention to be treated, whereas they are nearly eradicated when using the Ilizarov device. Non-union, mal-union and delayed union are also quite common incidences while using internal fixation, and also need the arrangement of another operative procedure for the management of these complications. The Ilizarov principles conservatively and simply manage these types of complications. Also there is the very clear advantage of the Ilizarov device over internal fixation of not needing an operation for implant removal.
The Ilizarov external fixator may be an appealing method of treatment of comminuted subtrochanteric fractures of the femur, after considering all the fore mentioned advantages over conventional internal fixation methods. However, one should be aware of some of its drawbacks. The most important of these are:
• The need for high patient selection and counseling, as non compliance or psychological instability may be hazardous to the final outcome.
• The constant need of monitoring of the device.
• The large size of the device makes it uncomfortable and unpleasant for the patient.
Finally, the Ilizarov external fixator is not the same as any other external fixator. The use of the Ilizarov device should be confined only to the surgeons with the adequate training and proper knowledge of the Ilizarov principles. The Ilizarov “magic” will only appear with the knowing hands.