title: Retrograde nailing with subsequent screw fixation for ipsilateral femoral shaft and neck fractures.
abstract: BACKGROUND
  Although ipsilateral femoral shaft and neck fractures are difficult to treat, there is still no consensus on the optimal treatment of this complex injury. We report the results of treating the 17 fractures with a standard protocol of retrograde nailing for diaphyseal fractures and subsequent screw fixation for the femoral neck fractures.
  
  
  METHODS
  Seventeen injuries (16 patients) sustained femoral shaft fractures, which were treated with retrograde intramedullary nails and subsequent screw fixation. Femoral neck fracture was noted before the operation in all patients except one. A femoral shaft fracture was always addressed first with unreamed retrograde nailing. Then, the femoral neck fracture was treated by cannulated screws or dynamic hip screw according to the level of fracture.
  
  
  RESULTS
  The average time for union of femoral shaft fractures was 27.3 (14-60) weeks. Nonunion occurred in five patients, who required bone grafts or changes of fixation. The average time for union of femoral neck fractures was 11 (8-12) weeks. All united, except for one case of nonunion with avascuar necrosis, which was a Garden stage IV fracture. Functional results using Friedman-Wyman criteria were good in 16 cases, and fair in one. The only fair result was nonunion of the femoral neck, which had the joint arthroplasty.
  
  
  CONCLUSIONS
  Retrograde nailing of femoral shaft fractures can provide an easy fixation and a favorable result for ipsilateral femoral neck fractures.
authors.affiliation: Department of Orthopedic Surgery, Kyungpook National University Hospital, 50, Samdok, Chung-gu, Daegu 700-721, South Korea. cwoh@knu.ac.kr
authors.forename: Chang-Wug
authors.initials: CW
authors.lastname: Oh
authors.forename: Jong-Keon
authors.initials: JK
authors.lastname: Oh
authors.forename: Byung-Chul
authors.initials: BC
authors.lastname: Park
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Jeon
authors.forename: Hee-Soo
authors.initials: HS
authors.lastname: Kyung
authors.forename: Shin-Yoon
authors.initials: SY
authors.lastname: Kim
authors.forename: Il-Hyung
authors.initials: IH
authors.lastname: Park
authors.forename: Oog-Jin
authors.initials: OJ
authors.lastname: Sohn
authors.forename: Woo-Kie
authors.initials: WK
authors.lastname: Min
mesh_terms: D000328:Adult; D001858:Bone Nails; D001863:Bone Screws; D005260:Female; D005264:Femoral Fractures / Q000601:surgery; D005265:Femoral Neck Fractures / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged