Unstable trochanteric fractures. A comparative analysis of four methods of internal fixation.

A series of 1,071 patients with unstable trochanteric fractures were treated by the McLaughlin or Jewett nail-plate, the sliding screw-plate or condylocephalic nailing according to Ender. Deep infection was encountered in 2.5% of the cases following surgery in the hip region and in 3.3% of the Ender nailings. Statistical analyses showed that the quality of the reduction was determined by the comminution of the fracture, and the technical failure of fixation or secondary displacement of the fracture was determined by the quality of the reduction. Sliding screw-plate fixation was found to be the only suitable fixation method for unstable trochanteric fractures, because of a low failure rate, a low re-operation rate and the possibility of secondary impaction without disturbing the fracture union.