[Ender nailing in fractures of the proximal femur. II. Analysis of our cohort]. 1989

J Bartonícek

The work presents the analysis of the group of 172 patients with the fracture of the proximal femur treated by the technique of Ender nailing between June 1985 and December 1988. The group comprised 45 male (26 per cent) and 127 female (74 per cent) patients. Their average age was 76 years (ranging from 20 to 97 years of age) out of which 75 per cent of patients were older than 70 years and 40 per cent older than 80 years. Indication of Ender nailing in patients under 60 years of age we consider exceptional. In our group we operated on in total 14 patients under 60 years of age (ranging from 20 to 57 years of age) and namely in case of the comminuted type of fracture increased risk of infection or serious total condition. The whole group was operated on by 21 variously experienced surgeons. 147 operations were performed in the general anesthesia and 25 in the epidural one. The fractures of the proximal femur were divided into basicervical--10 (6 per cent), stable pertrochanteric 96 (56 per cent), unstable pertrochanteric--38 (22 per cent), per-subtrochanteric--19 (11 per cent) and subtrochanteric--9 (5 per cent). For the objective evaluation we compared our classification of the fracture of the trochanteric part with these of Evens, Kyle and Jensen. For stable fractures we considered the types I and II according to Kyle, for unstable the type III of Kyle classification. Per-subtrochanteric fractures (Kyle IV) we singled out for their seriousness as a separate group of unstable pertrochanteric fractures. Almost the same spectrum of fractures was in the group of 108 patients in which we evaluated longterm results. The minimum observence period was 3 months the mean period 6.3 months. Almost all patients from this group were followed up until complete healing. The mean duration of operation was 52 minutes, the mean duration of anesthesia was 81 minutes and the duration of X-ray exposure was 2.6 minutes. These data were calculated also for individual types of fractures. In this case the time intervals differed according to the seriousness of the fracture. The comparison of our time data with other authors reliably evaluating the results of Ender nailing has proved that it is necessary to free this intervention from the myth of a quick and easy operation. The average number of nails inserted in one patient was 3.6.(ABSTRACT TRUNCATED AT 400 WORDS)

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D001858 Bone Nails Rods of bone, metal, or other material used for fixation of the fragments or ends of fractured bones. Bone Pins,Bone Nail,Bone Pin,Nail, Bone,Nails, Bone,Pin, Bone,Pins, Bone
D005593 Fracture Fixation, Internal The use of internal devices (metal plates, nails, rods, etc.) to hold the position of a fracture in proper alignment. Osteosynthesis, Fracture,Fixation, Internal Fracture,Fixations, Internal Fracture,Fracture Fixations, Internal,Fracture Osteosyntheses,Fracture Osteosynthesis,Internal Fracture Fixation,Internal Fracture Fixations,Osteosyntheses, Fracture
D006620 Hip Fractures Fractures of the FEMUR HEAD; the FEMUR NECK; (FEMORAL NECK FRACTURES); the trochanters; or the inter- or subtrochanteric region. Excludes fractures of the acetabulum and fractures of the femoral shaft below the subtrochanteric region (FEMORAL FRACTURES). Femoral Trochlear Fractures,Intertrochanteric Fractures,Subtrochanteric Fractures,Trochanteric Fractures,Trochlear Fractures, Femur,Femoral Trochlear Fracture,Femur Trochlear Fracture,Femur Trochlear Fractures,Fracture, Femoral Trochlear,Fracture, Femur Trochlear,Fractures, Femoral Trochlear,Fractures, Femur Trochlear,Fractures, Hip,Fractures, Intertrochanteric,Fractures, Subtrochanteric,Fractures, Trochanteric,Trochlear Fracture, Femoral,Trochlear Fracture, Femur,Trochlear Fractures, Femoral
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old

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