A sliding screw plate is the most commonly used device for the fixation of intertrochanteric hip fractures, providing secure fxation and controlled impaction but several complications, such as penentration of lag screw, back out of lag screw, wide skin incision and relatively long operation time, have been reported. An intramedullary device has been introduced as an alternative method. Ender nailng for intertrochanteric fracture of femur has many advantages such as minimal operative trauma and blood loss, short operation time, low incidence of infection, good stability of fracture and early ambulation.
The authors have treated 45 cases of intertrochateric fracture from March 1988 to July 1994 with sliding screw plate(25 cases) or Ender nailing(20 cases).
The results are as follows :
1. The ratio between men and women was 1 : 1.5 and the average age was 69 years old.
2. The most common causes were slip down injury followed by traffic accident and fall down injury.
3. Follow-up period was 16 to 34 monthes(average 23 monthes).
4. The most common type of fractures was Tronzo type III.
5. The average bony union time was about 14.2 weeks in sliding screw plate group and 15.1 weeks in Ender nailing group.
6. The most common complications were progressive varus deformity in SSP group and pain & limited ROM of knee joint in Ender nailing group.
7. The outcome was satisfactory in both group.