Rappold G, Schürer-Waldheim H
Chirurgische Abteilung, A. ö. Krankenhauses Zwettl/Niederösterreich.
Aktuelle Traumatol. 1991 Feb;21(1):20-3.
Since the introduction of the dynamic hip screw to stabilize fractures of the coxal end of the femur Endernails are being used less and less with some teams no longer using them at all. Nevertheless, the use of Endernails appears to be advantageous when the coxal end of the femur is fractured, especially in the case of osteoporotic bones and in elderly patients. We report on 61 instances in which we used Endernails on patients whose average age was 85.5 years. The infection rate of 1.6% was very low and 50 patients were fully ambulant. 19.6% of our patients died in the postoperative phase in the hospital whereas 1/3 of the patients operated died within one year. Complications in the post-operative phase were nail-gliding which occurred in 8 cases while another patient developed a pseudarthrosis in the region of the fracture. Post-operative care check-ups revealed that 7 patients suffered from a secondary dislocation of the fracture, in 4 instances leg length remained foreshortened by more than 2 cm. In one case the final position of the operated leg remained in an outside rotation. In view of the advanced age and therefore limited mobility of all the patients mentioned, adverse post-operative consequences are irrelevant.
自从动力髋螺钉被用于稳定股骨髋端骨折以来，Endernails的使用越来越少，有些团队甚至完全不再使用。然而，在股骨髋端骨折时，尤其是骨质疏松性骨骼和老年患者中，使用Endernails似乎具有优势。我们报告了61例使用Endernails治疗的患者，这些患者的平均年龄为85.5岁。1.6%的感染率非常低，50例患者能够完全行走。我们的患者中有19.6%在术后住院期间死亡，而接受手术的患者中有1/3在一年内死亡。术后并发症包括8例出现钉滑移，另有1例患者在骨折部位形成假关节。术后护理检查发现7例患者骨折出现继发性脱位，4例患者腿长缩短超过2厘米。有1例患者手术腿的最终位置保持在外旋状态。鉴于上述所有患者年龄较大且行动能力有限，术后不良后果无关紧要。
