Trochanteric fractures--a clinical and radiologic evaluation of McLaughlin, Ender, and Richard's osteosynthesis

Four hundred and thirty femoral trochanteric fractures operated with nail-plate (McLaughlin), Ender, or sliding screw-plate (Richard) osteosynthesis were followed up radiographically and clinically. For each method of osteosynthesis the initial nail position was correlated to the occurrence of late mechanical complications. Unstable fractures were associated with a higher incidence of one or more clinical complications such as repeated surgery, post-operative death, or increased pain. For Ender osteosynthesis correlations were found between several mechanical and clinical complications, while for Richard's osteosynthesis mechanical complications were significantly correlated to repeated surgery only. McLaughlin and Ender osteosyntheses had a higher incidence of reoperations than Richard's osteosynthesis, whereas the mobility and ADL function were the same at 4 months.