Functional outcome of elastic nail fixation for Intertrochanteric fracture in medically high-risk elderly
Abstract
Introduction: Intertrochanteric fractures in elderly population are major health problem. There are so many implants available to treat these fractures. We used enders nail for intertrochanteric fractures in medically compromised and high-risk patients.
Material and method: Twenty-seven patients of intertrochanteric fractures of femur were operated by condylocephalic ender’s nail. We included elderly patient with age more than 60 year with high risk and medically compromised conditions. The clinical and radiographically assessment was done in all cases at 4-week, 6-week, 12 week and 6 months.
Results: Fracture healing was achieved in average 12.5 week (ranging from 10 week to 24 week). The mean Harris score was 82.
Conclusion: Our experience suggests that the chief indication of enders’ nail fixation is in the treatment of intertrochanteric femur fracture in critically ill patient who cannot tolerate anaesthesia for an hour and more. Ender’s nailing appears the least traumatic form of internal fixation.
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References
2. Brauer CA, CoCa-Perralion M, Cutler DM, Rosen AB. Incidence and mortality of hip fracture in the united states JAMA. 2009;302 (14):1573:302
3. Roberts KC,BroxWT, Jevesevar DS, Sevarino K. Management of hip fracture in the elderly. J Am AcadOrthop Surg. 2015:23(2):131-137
4. Braithawaite Rs , Col NF . Wong JB. Estimating hip fracture morbidity, mortality and costs . J Am Geriator soc 2003;35(9) :753 -765.
5. Silva Mj. Biomechanics of osteoporosis fractures Injury 2007;38
6. Bijhler J. (1975) Percutaneous intramedullary nailing of intertrochanteric fractures. In: The Hip, Proceedings of the Hip Society. Mosby, St Louis, pp. 170-179
7. Einoder B. J. (1978) Ender nailing for proximal fractures. J. Bone Joint Surg. 618,239, (Abstract).
8. Ender H. G. (1973) Fixation Trochanterer Mit Fedemageln Nach Ender und Simon-Weidner. Lagenbecks. Arch. Chir. 332,935
9. Kuderna H., Bohler N. and Collon D. J. (1976) Treatment of intertrochanteric and subtrochanteric fractures of the hip by the Ender method. J. Bone Joint Surg. 58A, 604
10. Iwegbu C. G. (1980) The place of Ender’s nails in the evolution of methods of treatment of trochanteric fractures of the femur. M.Ch.Orth. Thesis, University of Liverpool.
11. Wynn Jones C., Morris J., Hirschowitz D. et al. (i977) A comparison of the treatment of trochanteric fractures ofthe femur by internal fixation with a nail plate and the Ender technique. Injury9,35.
12. . Nordin S, Zulkifil O, Faisham WI. Mechanical failure of DHS fixation in intertochanteric fracture femur. Med J Malaysia 2001;56:12-7.
13. Moon MS, Woo YK, Kim ST. A clinical study of trochanteric fractures of the femur: Outcome of the treatment in regard to osteoporosis and type of the treatment. I Korean Orthop Assoc 1991;26:1693702
14. Hall LG. Comparison of nail-plate fixation Ender’s nailing for intertrochanteric fractures. J Bone Joint Surg 1981;63-B:24-8.
15. Russian LA, Sonni A. Treatment of intertrochanteric and subtrochanteric fractures with Ender intramedullary rods. Clin Orthop 1980;148:203-12.
16. Emami M, Manafi A, Hashemi B, Nemati A, Safari S (2013) Comparison of intertrochanteric fracture fixation with dynamic hip screw and bipolar hemiarthroplasty techniques. Arch Bone Joint Surg 1:14– 17
17. an KP, Mohan R, Newman RJ (2002) The Gotfried percutaneous compression plate compared with the conventional classic hip screw for the fixation of intertrochanteric fractures of the hip. J Bone Joint Surg Br 84:1922
18. M.ROOFMAN , L. SOLOMAN . Enders nail fixation for intertrochanteric fracture, department of orthopaedics surgery , university of Witwatersrand and johannesberg Hospital , johannesberg.
19. Garg B, Marimuthu K, Kumar V, Malhotra R, Kotwal PP (2011) Outcome of short proximal femoral nail antirotation and dynamic hip screw for fixation of unstable trochanteric fractures. A randomised prospective comparative trial. Hip Int 21:531–536
20. Adams CI, Robinson CM, Court-Brown CM, McQueen MM (2001) Prospective randomized controlled trial of an intramedullary nail versus dynamic screw and plate for intertrochanteric fractures of the femur. J Orthop Trauma 15:394–400
21. Saudan M, Lubbeke A, Sadowski C, Riand N, Stern R, Hoffmeyer P (2002) Pertrochanteric fractures: is there an advantage to an intramedullary nail?: a randomized, prospective study of 206 patients comparing the dynamic hip screw and proximal femoral nail. J Orthop Trauma 16:386393
22. Zeng C, Wang YR, Wei J, Gao SG, Zhang FJ, Sun ZQ, Lei GH (2012) Treatment of trochanteric fractures with proximal femoral nail antirotation or dynamic hip screw systems: a metaanalysis. J Int Med Res 40:839–851 ayali C, Agus H, Ozluk S (2006) Treatment for unstable intertrochanteric fractures in elderly patients: internal fixation versus cone hemiarthroplasty. J Orthop Surg 14:240–244
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