[Surgery of fractures in the trochanteric region using Ender's method]

Our population is aging. The number of old persons is increasing and therefore we meet with fractures in the pertrochanteric region more frequently. We found that with proper indication osteosynthesis with Ender's nails has an advantage over other methods. The procedure is brief, it is not shock-producing and we can carry it out under spinal anaesthesia. By no other method known to us is it possible to mobilize the patient and to allow full weightbearing immediately after surgery. This results in the reduction of the high mortality which is a consequence of cardial and pulmonary complications. The urgent operation is carried out 8-10 hours after injury. Ender's elastic osteosynthesis was introduced in 1984 and so far 240 operations were performed. The average age of our patients was 75. Our oldest patient was 99, our youngest 37. We had 24 fatal outcomes, the majority during the period of introduction of the method. Observed retrospectively, in some cases death was the result of dubious indication.