[Ender Nailing in Proximal Femur Fractures Part III: Outcomes and Analysis of Complications.].
The article summarizes outcomes and complications of Ender nailing in the group of 172 patients with the fracture of proximal femur. Dominating in this group were pertrochanteric fractures. Average age of patients was 76 year, 74 % were female patients. Average time of surgery was 52 min., the duration of x-ray exposure was 2,6 min. The final outcomes with the minimal follow-up of 3 months were evaluated in the group of 109 patients as by that time 63 patients had died. In total, 107 fractures treated by Ender nailing healed, however, 6 reoperations had to be made. In the remaining 2 cases it was necessary to choose another technique for reoperation. In these 107 patients the resulting position was evaluated as good in 94 cases, as fair in 6 patients and as poor in 7 cases. In total there occurred 28 (16 %) peroperative complications the most serious of which was supracondylar fracture of femur (4times). Postoperatively we recorded 45 complications. Four most frequent and most serious complications were defined and analyzed in detail. Supracondylar fracture of femur occurred 10times, perforation of head also 10times, migration of nails distally 16ti-mes and mechanical failure (varus position of fragments) 18times. In addition, most patients complained of the pain in the knee joint. Analysis has shown that surgical technique in Ender nailing has its regularities which have to be respected. On the basis of subsequent experience in the application of Gamma nail and dynamic hip screw (DHS) we refrained from using Ender nailing in fractures of proximal femur due to a significant number of complications. Key words: Ender nailing, fractures of proximal femur, outcomes and complications, pertrochanteric fractures.
Bartonícek
J
J
Ortopedicko-traumatologická klinika 3. LF UK a FNKV, Praha.