A comparison of fixation with Ender nail and sliding screw plate in intertrochanteric fractures of elderly patients

Song, Joo Hyoun; Kang, Yong Koo; Lee, Han Yong; Koh, Hae Seok; Rhyu, Kee Won; Lee, Kwang Won

Abstract

In order to investigate the correlation between morbidity of the elderly patients and method of fixation, we analyzed 39 elderly patients had undergone internal fixation with Ender nail or sliding screw plate for the intertrochanteric fractures of the femur from January 1992 through December 1995. Among the 39 patients, 20 patients and 20 fractures were treated with Ender nail. Mean follow-up period was 26 months and average in age was 76.2 years Remaining 19 patients, 19 fractures were treated with sliding screw plate Mean follow-up period was 25 months and average in age was 75.4 years. The results obtained were as follows : 1. In the cases where Ender nails were used, the average operation time took in the average of 45 minutes and whereby, in the cases where sliding screw plates were used, took in the average of 110 minutes. 2. During the operation time, the amount of hemorrhage in the cases of Ender nail was about 100ml and the sliding screw plate resulted in about 350 ml. And the average amount of transfusion was 0.9 pints in cases of Ender nail and 2.3 pints in cases of sliding screw plate. 3. Among 20 patients fixed with Ender nail, only 2 patients had to be cared at ICU, but 9 of 19 patients had to be cared at ICU in the cases of sliding screw plates. 4. In the cases of Ender nail, the radiologic bony union time was about 13.4 weeks and they could walk with supports with in a week. But, in the cases of sliding screw plate the radiologic bony union time was about 16.2 weeks and they could walk with orthrosis at 28.4 days postoperatively. 5. Most patients treated with Ender nail were suffered from the problem at knee and protrusion of Ender nail into the hip joint, backing out of nail through the entry, coxa valga deformity were major complications after the operation. In the cases of sliding screw plates, loosening of sliding screw with coxa vara deformity, wound infection and delayed union were major complications. 6. Despite of many complications, if the indication is chosen well, the fixation with Ender nail will result in a benefical treatment method in the elderly patients for its advantages in general condition of the patients.