[Treatment of intertrochanteric fractures of the femur with Ender nails in patients over the age of 65 years].

OBJECTIVES

We evaluated the results of treatment with Ender nails in intertrochanteric fractures of the femur in patients exceeding the age of 65 years.

METHODS

Thirty-three patients (18 women, 15 men; mean age 78 years; range 65 to 98 years) were treated with Ender nails for non-pathological fractures of the intertrochanteric part of the femur. The right hips were involved in 17 patients and the left in 15 patients. One patient had bilateral involvement. Serious complicating diseases existed including cardiovascular disease (n=12), pulmonary disease (n=11), and others (n=10) such as diabetes mellitus. According to the Evans-Jensen classification, there were 14 type 1, five type 2, four type 3, four type 4, and seven type 5 fractures. The mean follow-up was 20 months (range 5 to 78 months).

RESULTS

The mean length of hospital stay was 15 days (range 9 to 18 days). Mortality was encountered in 10 patients (30.3%) within the first postoperative year, two of whom (6%) died during hospitalization. Twelve patients were alive on final follow-ups, of these eight patients were ambulatory without any significant problem. Postoperatively, one patient developed electrolyte imbalance, and another had urinary infection. Due to migration problems, one of the three nails had to be removed in the early period in one patient, and all nails in five patients after the union was obtained. Union was obtained in all patients within a mean of eight weeks (range 6 to 18 weeks).

CONCLUSION

Ender nailing may be appropriate in stable, non-displaced intertrochanteric fractures in the elderly, as it is associated with lower mortality in the early period.