title: A comparative study of ipsilateral intertrochanteric and femoral shaft fractures treated with long proximal femoral nail antirotation or plate combinations.
abstract: OBJECTIVE
  To compare the results of long proximal femoral nail antirotation (PFNA-long) and plate combinations in the treatment of ipsilateral intertrochanteric and femoral shaft fractures.
  
  
  METHODS
  Between March 2004 and April 2009, 23 patients with ipsilateral intertrochanteric and femoral shaft fractures were treated with PFNA-long or plate combinations. The patients were divided into two groups. Group I contained 13 patients who were treated with dynamic hip screws (DHS) combined with compression plate fixation. The 10 patients in Group II were treated with PFNA-long.
  
  
  RESULTS
  The average follow-up was 17.8 and 16.8 months for Groups I and II, respectively. The average union time for intertrochanteric fractures was 17.4 and 16.6 weeks in Groups I and II, respectively, and for femoral shaft fracture 22.2 and 21.5 weeks, respectively. There were nine good, two fair, and two poor functional results in Group I, and eight good, one fair, and one poor in Group II. There was nonunion of two femoral shaft fractures in Group I and one in Group II. There were no significant differences between the two groups in functional outcomes or major complications.
  
  
  CONCLUSIONS
  Both treatment methods achieve satisfactory functional outcomes in patients with ipsilateral intertrochanteric and femoral shaft fractures. PFNA-long is the better choice for the treatment of complex fractures, having the advantages of minimal exposure, reduced perioperative blood loss, and achievement of biological fixation of both fractures with a single implant.
authors.affiliation: Department of Orthopaedic Surgery, Guang'anmen Hospital, China Academy of Chinese Medicine Science, Beijing, China.
authors.forename: Wen-yue
authors.initials: WY
authors.lastname: Wang
authors.forename: Tian-fu
authors.initials: TF
authors.lastname: Yang
authors.forename: Lei
authors.initials: L
authors.lastname: Liu
authors.forename: Fu-xing
authors.initials: FX
authors.lastname: Pei
authors.forename: Li-ming
authors.initials: LM
authors.lastname: Xie
mesh_terms: D000328:Adult; D001858:Bone Nails; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D006620:Hip Fractures / Q000601:surgery; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult