title: Use of reconstruction nails to manage ipsilateral displaced femoral neck-shaft fractures: assessment of a new approach.
abstract: OBJECTIVE
  Owing to unpredictable femoral neck reduction, reconstruction nails are not suitable for fixation of group 3 ipsilateral femoral neck-shaft fractures. We developed a new one-step fixation technique to overcome this problem. This study aims to assess this new technique at the Orthopaedic Department, Chi-Mei Foundation Medical Center, Tainan.
  
  
  METHODS
  Of 31 consecutive patients with femoral fractures treated by reconstruction nails, five patients had group 3 ipsilateral femoral neck-shaft fractures, 4 of whom were treated by a new surgical technique. Two 5.0-mm drills were firstly inserted to tether the trochanter fragment, and distal locking screws were secondly applied to immobilise the shaft fracture. The neck-shaft angle was then restored in a closed fashion and proximal cephalomedullary screws were attached. Patients were followed up by post-operative radiography.
  
  
  RESULTS
  All 5 cases of group 3 ipsilateral femoral neck-shaft fracture obtained radiographic union without significant surgical sequelae. Three of the patients had implants removed. No patients presented with osteonecrosis at the 3-year follow-up.
  
  
  CONCLUSIONS
  The new approach to manage ipsilateral femoral neck-shaft fractures by using reconstruction nails obtains relatively good clinical results.
authors.affiliation: Orthopaedic Department, Chi-Mei Foundation Medical Center, 901 Junghua Road, Yungkang City, Tainan, Taiwan. dantina@ara.seed.net.tw
authors.forename: S H
authors.initials: SH
authors.lastname: Lin
authors.forename: C W
authors.initials: CW
authors.lastname: Lo
authors.forename: S C
authors.initials: SC
authors.lastname: Cheng
authors.forename: M Y
authors.initials: MY
authors.lastname: Kuo
authors.forename: L S
authors.initials: LS
authors.lastname: Chin
mesh_terms: D000328:Adult; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005471:Fluoroscopy; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome