Use of reconstruction nails to manage ipsilateral displaced femoral neck-shaft fractures: assessment of a new approach.
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.
Lin
S H
SH
Orthopaedic Department, Chi-Mei Foundation Medical Center, 901 Junghua Road, Yungkang City, Tainan, Taiwan. dantina@ara.seed.net.tw
Lo
C W
CW
Cheng
S C
SC
Kuo
M Y
MY
Chin
L S
LS
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