Intertrochanteric fracture of the hip. Comparison of nail-plate fixation and Ender's nailing.

Between April 1979 and August 1983, 201 patients with intertrochanteric fractures of the hip were admitted to Haife Medical Center (Rothschild), Israel. These patients were randomely divided into two groups: 104 patients underwent fixation with a compression screw and plate (Richard's Co.) and 97 patients underwent fixation with Ender's nails. The results of both groups were analyzed and evaluated clinically, economically, and socially. There were differences in operative time, incidence of infection, local complications, and functional capacity, but, on the other hand, no difference in the length of hospital stay. The perioperative mortality was significantly higher in the group that underwent fixation with Ender nails (seven to one), but the overall mortality was the same for both groups. The advantages of the Ender method are a quicker surgical procedure, diminished blood loss, and practically no risk of deep infection. The fixation with compression screw and plate assures a better anatomical reduction of the hip with fewer local complications and a better functional result, but carries a higher risk of infection.