Supracondylar femoral fractures as a complication to Ender nailing of trochanteric fractures. A new device for osteosynthesis.

Supracondylar femoral fractures is an uncommon complication to Ender nailing of a trochanteric fracture. Seven cases were traced to study the fracture pattern and the results of the therapy. The most common fracture type extends obliquely from the hole of the insertion medially in a proximo-lateral direction. Prolonged traction in bed in these cases should be avoided. Rigid internal fixation using angle blade plates if frequently insufficient in highly osteoporotic bone. As an alternative to both traction in bed and rigid fixation a new osteosynthetic device for semielastic fixation was used as demonstrated in two of these cases. It has a connection piece between one elastic intramedullary nail of the Ender type and two cancellous bone screws. The device, applied from the medial as well as the lateral condyle, ensures a fixation less prone to mechanical failure in osteoporotic skeleton. It does not interfere with the loading forces of the bone and is stable enough to allow patients to be mobilized from bed. We now use it for all types of distal femoral fractures.