Femoral Shaft Fracture Treated with Flexible Intramedullary Ender Nail

Lee, Beom Koo; Kim, Young Ju; Yoon, Suk Woong; Cho, Jae Hee; Lee, Byung Gug

Abstract

Various methods have been used in the treatment of femoral shaft fractures. Recently closed intramedullary interlocking nailing is recommended as one of the most successful methods, but its use is technically demanding and much exposure to radiation is needed. In comparison, flexible intramedullary nail such as Ender nail is easy to use and cause less damage to the patient. We used the Ender nail in the treatment of femoral shaft fracture from 1989 to 1993 and the result were as follows; 1. Average patient age is 38.2 years old and major cause of the fracture was traffic accident. 2. Bony union was obtained in 14 cases of 17 cases with primary operation. Average bony union time was 14.2 weeks. 3. Mean operative time was 40 minutes in Winquist-Hansen type I and II ,90 minutes in Winquist-Hanserl type III and IV. 4. Ender nail migration over 10mm was noted in 9 of 17 cases. Average migration was 10mm in knee and 24mn in trochanteric area. 5. Complication were as follows ; Nail migration causing pain in 9 cases, delayed union 4 cases, non-union 3 cases, varus deformity in 3 cases, shortening in 4 cases. In Winquist-Hansen type III and IV ,76.9% of cases suffered from some complication. 6. Flexible intramedullary nail was easy to apply but we thought that Ender nail is inadequate treatment method for Winquist-Hansen type III and IV because of high complication rate.