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Forty-one femoral shaft fractures were treated with flexible Ender nails which were introduced through the great trochanter without reaming of the medullary canal. There was one case of intraoperative femoral neck fracture. No wound infection or osteomyelitis occurred. Axial and rotational malalignment was always due to technical errors. All fractures united at an average of 12 weeks. Transverse fractures, short oblique and those with "unicortical" comminution proved to be stable after Ender nailing, while cases with "bicortical" comminution had tendency for bone shortening and often required additional procedures.
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