Treatment of intertrochanteric fracture in elderly patients by combined Ender nailing and Knowle's pinning: A technical note

Since the introduction of the Ender nail in the treatment of intertrochanteric fractures, it has had a high reputation and has been popular for the treatment of intertrochanteric fractures. It was introduced by Ender and other earlier authors to provide secure fixation and allow early mobilization with a high success rate. However, clinical experience of the Ender nail by later authors, including ourselves, reveal that Ender nailing alone cannot provide secure fixation, especially in unstable fractures with osteoporosis and a wide medullary canal. Therefore we introduced a combined fixation procedure using Ender nails and Knowle's pins to provide better fixation for the intertrochanteric fracture, which brings more promising results.