Closed intramedullarynailing for trochanteric fractures of femur has has many advantages such as minimaloperative trauma, low incidemce of infection, good stability of fracture, low incedence of delayed union or nounion.
Complications have been frequently experienced especially in eledrly, osteoporotic patients, but these could be avoided by meticulous surgical procedure.
@ES The authors have treated 140cases of intertrochanteric fracture and 28 ccases of subtrochanteric fracture and 128 cases of subtrochanteric fractrue from March 1982 to September 1991 with Ender nailing the results are
summarized
as
follows:
@EN 1. The average age was 61.5yrs.
2. In classification of intertrochanteric fracture, stable fractures(Kyle type 1 & II) were 77cases (46%) and unstable fractures(Kyle type III & IV)were 63cases(37%). And in subtrochanteric fracture, stable transverse fractures
were
14 cases(8.5%) and unstable long olblique or spiral fracures were 14 cases(8.5%).
3. Intraoperative complications were experienced in 27 cases(16%).
4. Of the 115 patients with more than 6 months' follow-up, 27 patients showed more than one complication, e.g, knee joint pain in 5 patients, external rotation defornity in 9patients, nail migration in 9 patients, and fixation loss in 4
patients
including one case of shortening and one case of nonumion with nail breakage.
5. Compolications occurred more frequently in unstble fracturese(28.9%) and in over 50yrs. of ages(26%) than in stable fractures and in below 50yrs. And it was felt that complications could be minimized by packing of the medullary canal with
nails.
6. It is thought that ender nailing is a good treatment method for trochanteric fractures of femur not only in elderly debilitated patients but also in young patients.
However, experience and caution are required to prevent complications.
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