Pankovich A M, Goldflies M L, Pearson R L
J Bone Joint Surg Am. 1979 Mar;61(2):222-32.
Closed Ender nailing was used in sixty fractures of the femoral shaft. Follow-up examination in fifty-two cases is reported. There were only two failures of the method, both in fractures with supracondylar extension. Simple transverse and short oblique fractures and those with unicortical comminution were shown to be stable after nailing, while long oblique fractures and lesions with bicortical comminution had a tendency to shorten and often required cerclage wiring, cast-bracing, or traction. The average hospital stay was 23.7 days. The operations were simple and quick. There was one case of osteomyelitis, one of clinically apparent thrombophlebitis, and one of fat-embolism syndrome in a patient with multiple fractures and multisystem injuries. There were no cases of breakage of the nail, delayed union, or non-union. In most cases knee motion returned to the preinjury level, although in five knees removal of the nails was necessary. The two failures of nailing which required plate fixation occurred in fractures extending into the supracondylar region. Therefore, these fractures are not suitable for Ender nailing.
对60例股骨干骨折采用闭合式Enders髓内钉固定治疗。现报道其中52例的随访情况。该方法仅有2例失败，均为髁上延伸型骨折。单纯横形和短斜形骨折以及单皮质粉碎性骨折在髓内钉固定后显示稳定，而长斜形骨折和双皮质粉碎性损伤有缩短倾向，常需环扎钢丝、石膏支具或牵引治疗。平均住院时间为23.7天。手术操作简单快捷。有1例发生骨髓炎，1例出现临床明显的血栓性静脉炎，1例多发骨折合并多系统损伤患者发生脂肪栓塞综合征。未出现髓内钉断裂、延迟愈合或不愈合病例。多数病例膝关节活动恢复到伤前水平，不过有5例膝关节需要取出髓内钉。2例髓内钉固定失败而需钢板固定的病例发生在延伸至髁上区域的骨折。因此，这些骨折不适合Enders髓内钉固定。
