Treatment of Trochanteric Fracture of the Femur with Flexible Intramedullary Nailing

Kim, Key Yong; Cho, Duck Yun; Lee, Joong Myung; Seo, Jung Ho

Abstract

The purpose of early reduction and internal fixation of the trochanteric fracture is early mobilization and reducing the complication rate. The morbidity and mortality rates remain high in elderly patients with this type of injury. This is due to reduced tolerance to prolonged bed rest, lenghy operation, and massive soft tissue dissection and blood loss. We feel the Ender method has the advantages of ease performance, decreased operating time, and immediate weight bearing in most cases. Total 23 cases of trochanteric fracture of the femur was treated at the Department of Orthopaedic Surgery of National Medical Center during the period from June, 1985 to December, 1987. The results were as follows : l. Out of 23 patients, 16 patients were female and the mean age was 71 year old. 2. The most common cause was the injury from slip down. 3. By the Tronzo classification, the most common type was type III. (14 cases) 4. The average duration from accident to operation was 4.5 days and average blood loss was 210 ml during operation. 5. The average bony union was obtained in 16.4 wks. 6. For prevention of distal pin migration, we performed circumferential wiring through the eye of distal pin in 6 cases and resulted in no migration until complete bony union.