Ender nailing For Intertrochanteric Fracture of the Femur in the Elderly patients

Jeong, Hak Yeong; Yang, Seung Wook; Shin, Seung Joon; Seung, Hyeong Joon

Abstract

The principle of treatment of intertrochanteric fracture is early operation and early rehabilitation. The morbidity and mortality associated with intertrochanteric fracture are remained high because the elderly patient generally have a reduced tolerance for prolonged bed rest, lengthy operation and blood loss. Since Ender introduced the concepts of multiple flexible intramedullary nailing in 1970, Ender nailing has been mostly used in intertrochanteric fracture of the elderly patient, but it has been rarely used for unstable fracture. The authors analysed 87 cases of intertrochanteric fractures of femur over 60 years old, treated with Ender nailing during period from July, 1998 to October, 1996. The results were as follows : 1. Among 87 cases, 70 cases were female and average age was 75.3 years old. 2. The common complications were knee pain and LOM(10%) and distal migration of nails(3%). 3. These complications were reduced by careful bending of nails, fanning of nails in femoral head, stacking of medullary canal and accurate placement of portal hole. 4. 10 patients died within 1 year(Mortality rate : 11%). 5. Thirty-six(47%) patients maintained their prefracture ambulatory ability at a postoperative 1 year ; Fourty-one(53%) patients lost some degree of ambulatory ability. 6. In unstable intertrochanteric fracture, we can achieved good results by Ender nailing in valgus reduction.