Treatment of pertrochanteric and subtrochanteric fractures of the femur by the Ender method.
The Ender method consists of insertion of round, flexible, condylocephalic intramedullary nails. In 104 patients with a median age of 77 years and 80% older than 70 years, the morbidity was high (owing to concomitant diseases in 73%). Follow-up examination of survivals showed good functional results. There was some tendency to shortening, more than 2 cm in 15% of the patients. External rotation deformity of more than 20 degrees was observed in 15% of patients. Towards the end of the series when precautionary measures were taken to avoid this, the number of patients with such deformity decreased. The advantages of the Ender method are: a short operation time, minor operative trauma and early mobilization and weight-bearing. Because of some rotational instability the method should be reserved for patients older than 65--70 years.