Difficulties and complications of the Ender method of treatment of trochanteric fractures of the femur.

The advantages of the Ender technique over the other methods of treatment of trochanteric fractures of the femur have been emphasized by several authors but the difficulties and complications of the method have perhaps not been sufficiently highlighted. With this imbalance in mind, 60 patients treated by the Ender method have been reviewed with particular emphasis on the problems encountered during treatment. The follow-up period ranges from 6 to 28 months. The main technical difficulties were experienced during the reduction and nailing of the comminuted and displaced fracture. The main postoperative complications were the cutting out of the nails from the head and neck fragment with weight bearing, backing down of the nails at the knee, and external rotation deformity. The early mortality, infection, delayed union and non-union rates were low.