[Ender nailing of hip para-articular fractures in advanced age]

Since the introduction of the dynamic hip screw to stabilize fractures of the coxal end of the femur Endernails are being used less and less with some teams no longer using them at all. Nevertheless, the use of Endernails appears to be advantageous when the coxal end of the femur is fractured, especially in the case of osteoporotic bones and in elderly patients. We report on 61 instances in which we used Endernails on patients whose average age was 85.5 years. The infection rate of 1.6% was very low and 50 patients were fully ambulant. 19.6% of our patients died in the postoperative phase in the hospital whereas 1/3 of the patients operated died within one year. Complications in the post-operative phase were nail-gliding which occurred in 8 cases while another patient developed a pseudarthrosis in the region of the fracture. Post-operative care check-ups revealed that 7 patients suffered from a secondary dislocation of the fracture, in 4 instances leg length remained foreshortened by more than 2 cm. In one case the final position of the operated leg remained in an outside rotation. In view of the advanced age and therefore limited mobility of all the patients mentioned, adverse post-operative consequences are irrelevant.