Clinical Study of Ender Nailing for Peritrochanteric Fractures of the Proxmal Femur

Special Reference to Gonalgia

Abstract

One complication of Ender nailing when used for peritrochanteric fractures of the proxmal femur is an outbreak of gonalgia. We analysed the cause of gonalgia, and considered ways of overcoming this problem.
Subjects included twenty-three cases (five males, eighteen females) ranging in age from 58-95 years (mean 80 years), whom we treated from April 1992 to December 1993.
Gonalgia was seen in twelve cases (52.2%). There was a correlation between gonalgia and projection of the pin on the medial epicondyle. Projection of the pin was due to operating technique, such as poor dispersion of the pin in the femoral head, the inserted position not fitting correctly and poor support on the medial epicondyle. To avoid these problems it is important that pin projection is avoided by studying the anatomical form of each case, by selecting a correctly fitting nail and by deciding on the bending position and angle of the pin.