[Ender nail with interlocking mechanism or dynamic hip screw in pertrochanteric fractures? A prospective study extending its limits].
In a prospective study on 148 patients with trochanteric fractures of the hip we compared the results of two implant-systems: the Ender-nailing modified by the dynamical interlocking method of Kempf and Bitar, and the dynamic hip screw (DHS) of the AO-ASIF. The Ender-method had the shorter operation time, earlier weight-bearing and less septic complications. Fracture consolidation was complete after three months in all cases. But in 8% reosteosynthesis because of hip joint perforations of nails was necessary. The method leads in less cases to anatomical reduction (85%), more often relevant varus (9%) and rotationary (14%) malpositions and functional deficits in hip (25%) and knee joints (9%), compared with the DHS. The DHS had less implant complications, reosteosynthesis was necessary in 4%. Technical failures were seldom. In 96% anatomical reduction could be achieved and the function of the hip was in 87% good to excellent. The Ender-nailing with dynamic interlocking is a system for internal fixation of trochanteric fractures in elder patients. The DHS-system has better functional results. Both systems need to be performed in a very careful, exact surgical procedure, to avoid complications.
Muller
B
B
Abteilung für Unfallchirurgie, Albert-Ludwigs-Universität Freiburg.
Bonnaire
F
F
Heckel
T
T
Jaeger
J H
JH
Kempf
I
I
Kuner
E H
EH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D017102:Fracture Healing / Q000502:physiology; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011446:Prospective Studies; D011859:Radiography; D012086:Reoperation
Ender-Nagel mit Verriegelung oder dynamische Hüftschraube bei pertrochantären Frakturen? Eine prospektive, grenzüberschreitende Studie.