Unfallchirurgie
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Comparative Study
[Ender nail with interlocking mechanism or dynamic hip screw in pertrochanteric fractures? A prospective study extending its limits].
In a prospective study on 148 patients with trochanteric fractures of the hip we compared the results of two implant-systems: the Ender-nailing modified by the dynamical interlocking method of Kempf and Bitar, and the dynamic hip screw (DHS) of the AO-ASIF. The Ender-method had the shorter operation time, earlier weight-bearing and less septic complications. Fracture consolidation was complete after three months in all cases. ⋯ The Ender-nailing with dynamic interlocking is a system for internal fixation of trochanteric fractures in elder patients. The DHS-system has better functional results. Both systems need to be performed in a very careful, exact surgical procedure, to avoid complications.
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246 patients (average 82.4 years) with proximal femur fractures treated with bipolar endoprosthesis, sliding lag screw or Ender nailing, related to the fracture type were analysed in a retrospective study. Pre-existing diseases, duration of operation, postoperative complications, transfusions, hospital stay, mobility achieved and mortality were noted. In result we found a high multimorbidity related to the age, the highest requirement of transfusions in patients undergoing Ender nailing, a long period to achieve postoperative mobility, a long hospital stay and increasing mortality with average age and average hospital stay.