Ender nailing of intertrochanteric and subtrochanteric fractures of the femur.

Abstract

Condylocephalic intramedullary Ender nailing of fractures of the proximal end of the femur offers four advantages. The operation is short and is minimally traumatic, with little blood loss. The patient returns to functional ambulatory status within a few days. Infection of the fracture site and at the nail portals is a negligible risk, and the risk of delayed union and non-union is greatly reduced. The method has also introduced a group of new complications such as irritation at the knee, decreased range of knee motion, and distal and proximal migration and penetration of the nails, yet these problems did not cause failures of the method. Osteoporosis was found to be a significant factor contributing to complications. External rotation deformity has not been a major problem in the present study and was improved by use of nails that had an anteversion bend. Delayed union was observed in only one patient with an intertrochanteric fracture which eventually healed. All subtrochanteric fractures healed within three months, which represents a favorable result in comparison with other methods.