Subtrochanteric fractures. Classification and results of Ender nailing.

With use of a simple classification based on anatomical criteria and anatomical function, 27 subtrochanteric fractures of the femur were studied. The series was derived from 156 elderly patients with extracapsular hip fractures, all of whom were operated on by the Ender method. There were no infections. Regarding intra- and postoperative bleeding, early mobilization, length of hospital stay, and final clinical outcome, the results were superior to those obtained with other methods so far presented. Three patients died within 3 months postoperatively. Technical failure occurred at an early stage in 4% and at a later stage in 12.5%. Short oblique fractures did not require any supplementary fixation. Neither comminution nor obliquity prevented early mobilization with full weight-bearing. Tibial traction for a short period in one patient did not prevent expected mechanical failure. The mean time in hospital was 19 days. The functional result was excellent or good in 79% of the patients.