Ender’s nail in the treatment of trochanteric fractures in older patients: report of 60 cases

The aim of this retrospective study is to evaluate the results of trochantericfractures treatment by Ender’s nail in older patients.The medical and radiological records of 96 patients with trochantericfractures treated by Ender’s nail from January 2000 to June 2002were reviewed. Subtrochanteric fractures were excluded. Patientswere operated under general or locoregional anesthesia, on a deferredemergency basis. The procedure was carried out on an orthopaedictable. The fracture reduction was carried out under radioscopy.Surgical planning consisted in measuring the nail’s size and thefemoral neck anteversion. The results were assessed according toclinical and radiological criteria.Sixty records were analyzed, comprising 40 women and 20 menfrom 62 to 110 years old with a median age of 68 years old. Theetiology was predominantly traumatic (99%). Ender’s classificationwas as follows: 32 stable fractures and 28 unstable fractures andmany per trochanteric fractures (66%). The reduction was anatomicalin 75% of the cases and the osteosynthesis was good in 65% ofthe cases. 55% of the patients could bear full weight on their lowerlimbs between day 10 and day 15. During the third month after theprocedure, we recorded 6 deaths, 4 nail descents, 5 vicious callus.At that time, 80% of the patients could stand on their feet. At sixthmonth, the mortality rate was 15%, 24% of the patients could walkwithout help, 55% needed help and 6% were confined to the bed.Ender nailing is a reliable method with functional results comparableto other more modern and expensive systems.