Closed Ender nailing was used in sixty fractures of the femoral shaft.
Follow-up examination in fifty-two cases is reported. There were only two
failures of the method, both in fractures with supracondylar extension.
Simple transverse and short oblique fractures and those with unicortical
comminution were shown to be stable after nailing, while long oblique
fractures and lesions with bicortical comminution had a tendency to shorten
and often required cerclage wiring, cast-bracing, or traction. The average
hospital stay was 23.7 days. The operations were simple and quick. There
was one case of osteomyelitis, one of clinically apparent thrombophlebitis,
and one of fat-embolism syndrome in a patient with multiple fractures and
multisystem injuries. There were no cases of breakage of the nail, delayed
union, or non-union. In most cases knee motion returned to the preinjury
level, although in five knees removal of the nails was necessary. The two
failures of nailing which required plate fixation occurred in fractures
extending into the supracondylar region. Therefore, these fractures are not
suitable for Ender nailing.