Background: There are several methods to manage intertrochanteric fractures. The external fixation device could produce favorable clinical outcomes. Furthermore, it has a lower rate of morbidity. Therefore, this study aimed to compare two different methods for the reduction of the intertrochanteric fracture in elderly high-risk patients : external fixator vs. skeletal traction.

Materials and Methods: In this randomized clinical trial, 60 elderly patients (mean age, 78 years) with a pertrochanteric fracture were randomly assigned to the two groups and treated with either skeletal traction (group A) or external fixation (group B).

Results: Significant improvements were observed in all fractures acceptable reduction was achieved in 8 patients in group A and 26 patients in group B. The mean length of hospitalization was 14.3 days for group A and 2.2 for the group B. There was a significant difference between the two groups regarding the acceptable reduction of fracture and duration of hospitalization (P<0.05). At 12 months after surgery, the mean Harris hip scores were 57 and 66 in the group A and B, respectively.

Conclusion: M anagement with external fixator is an effective method for intertrochanteric fractures in elderly high-risk patients. Its advantages include quick and simple application, minimal blood loss, less radiation exposure, early discharge from hospital, low costs and favorable functional outcomes.