Functional results of minimally invasive cheap fixation technique for all types of intertrochanteric femoral fractures using enders nail and cannulated cancellous screws


  • Ansari Muqtadeer A. Aziz Department of Orthopaedics, Government Medical College, Aurangabad, Maharashtra, India
  • Altamash A. Patel Department of Orthopaedics, Government Medical College, Aurangabad, Maharashtra, India
  • Pratik P. Rathod Department of Orthopaedics, Government Medical College, Aurangabad, Maharashtra, India



Cancellous screws, Endersnails, Intertrochanteric fractures


Background: The objective was to study functional results of fixation of intertrochanteric fractures of femur using enders nail and cannulated cancellous screws.

Methods: This was a prospective observational study. The study was conducted on 30 patients of intertrochanteric femoral fractures who underwent fixation by enders nailing and cannulated cancellous screws in Department of Orthopaedics, GMCH, Aurangabad from January 2018 to January 2021. Patients were assessed functionally using Harris hip score, visual analogue score, and radiological assessment at 3, 6, and 12 months.

Results: All patients showed radiological union within 3 months. Functional assessment was done with Visual analogue scale (VAS) in which mean VAS score was 0.9 (range 0-3), mean Harris hip score which was 86 (range 81-90). One patient developed superficial infection at incision site which was treated by giving appropriate antibiotics and one patient complained of prominent nail on medial side of knee which was treated by implant removal after union of fracture.

Conclusions: Fixation of intertrochanteric femur fractures using enders nailing and cannulated cancellous screws achieves good stability with minimal complications and improved patients’ outcome in terms of less intraoperative blood loss, less chances of infection, less operative time with minimal patient morbidity and good functional outcome.


Rockwood and Greens, fracture in adults, 8th edition: vol.2:2075-2130.

Hagino H, Furukawa K, Fujiwara S. Recent trend in the incidence and lifetime risk of hip fractures in Tottori, Japan. Osteoporos Int. 2009;20(4):543-8.

Lawton JO, Baker MR, Dickson RA. Femoral neck fracture: Two populations. Lancer. 1983;2:70-72.

Atkin JM. Relevance of osteoporosis in women with fractures of the femoral neck. Br Med J. 1984;288:597-601.

Pogrund H, Makin M, Robin G. Osteoporosis in patients with fractured femoral neck in Jerusalem. Clin Orthop.1977;124:165-72.

Ender J, Simon-Weidner R. Die Fixierung der trochanter bruche mit runden elastischen Kondylennageln. Acta Chir Austria. 1970;1:40.

Shrihari LK, Mannual S, Sapan DS. A clinical study of distal femoral fractures treated by retrograde femoral nailing- biological and biomechanical advantages with review of literature. Int J Orthopaedics Traumatology Surgical Sci. 2016;2(2):371-7.

Lovelock TM, Broughton NS, Williams CM. The Popularity of Outcome Measures for Hip and Knee Arthroplasties. J Arthroplasty. 2018;33(1):273.

Bonnaire F, Weber A, Bosl O, Eckhardt C, Schweiger, Linke B. "Cutting Out" in pertrochanteric fractures- problem of osteoporosis . Unfallchirurg. 2007;110:425-32.

Beidle SH, Patel AD, Butcher M, Calvert PT. Fixation of intertrochanteric fractures femur -randomized prospective comparison of gamma nail and dynamic hip screw. JBJS Br. 1991;73:330-4.

Nordin S, Zulkifil O, Faisham EK. Mechanical failure of DHS fixation in intertrochanteric fracture femur. Med J Malaysia. 2001;56:12-7.

Fogognolo F, Kfuri M, Paccola CA. Intramedullary fixation of pertrochanteric hip fractures with PFN. Arch Orthop Trauma Surg. 2004;124:31-7.

Pankovich AM, Tarabiski IE. Ender nailing of intertrochanteric fractures of femur. J Bone Joint Surg.1980;62A:635.

Cobelli NJ, Sadler AH. Ender rod versus compressive screw: Fixation of hip fracture. Clin Orthop. 1970;138:321.

Moon MS, Woo YK, Kim ST. A clinical study of trochanteric fractures of femur: Outcome of the treatment in regard to osteoporosis and type of the treatment. I Korean Orthop Assoc. 1991;26:1693-702.

Hall LG. Comparison of nail plate fixation Enders nailing for intertrochanteric fractures. J Bone Joint Surg. 1981;63-B:24-8.






Original Research Articles