Role of PFN in ipsilateral fracture neck and shaft femur: a single solution to double fracture
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20181472Keywords:
Ipsilateral, Proximal femoral nailAbstract
Background: Ipsilateral, concomitant femoral neck and shaft fracture is a rare fracture pattern that presents a diagnostic and treatment challenge. A variety of management modalities have been tried to treat this complex fracture pattern ranging from conservative approach to recently introduced proximal femoral nails (PFN).
Methods: We analysed the retrospective data of 25 consecutive patients who had sustained a high energy trauma who had concomitant ipsilateral fractures of the femoral shaft associated with proximal femur fractures treated with PFN between January 2010 and January 2017.
Results: Average follow up period was 1.2 years. All ipsilateral neck and shaft fractures were united with proximal femur nail (PFN). Neck fracture union averaged 4.3 months (range, 3–6 months). Shaft fracture union averaged 5.4 months (range, 4–7 months). Eighteen patients (70%) had a good functional result, five patients (21%) had fair result and in two patients the result (9%) was poor.
Conclusions: We observed although technically demanding, the reconstruction nail is an acceptable, cost effective and minimal invasive alternative for the management of concomitant ipsilateral fractures of the femoral neck and shaft, with a good functional outcome and fewer complications.
References
Wolinsky PR, Johnson KD. Ipsilateral femoral neck and shaft fractures. Clin Orthop. 1995;318:81-90.
Swiontowski M, Hansen S, Kellam J. Ipsilateral fractures of the femoral neck and shaft- a treatment protocol. J Bone Joint Surg Am. 1984;66:260–8.
Casey MJ, Chapman MW. Ipsilateral concomitant fractures of the hip and femoral shaft. J Bone Joint Surg Am. 1979;61:503– 9.
Bennett FS, Zinar DM, Kilgus DJ. Ipsilateral hip and femoral shaft fractures. Clin Orthop. 1993;296:168-77.
Gadegone WM, Salphale YS. Proximal femoral nail-an analysis of 100 cases of proximal femoral fractures with an average followup of 1 year. Int Orthop. 2007;31:403–8.
Swiontkowski M F. Ipsilateral femoral shaft and hip fractures. Orthop Clin North Am. 1987;18(I):73-84.
Friedman RJ, Wyman ET Jr. Ipsilateral hip and femoral shaft fractures. Clin Orthop. 1986;208:188-94.
Zettas JP, Zettas P. Ipsilateral fractures of the femoral neck and shaft. Clin Orthop. 1981;160:63–73.
Wiss DA, Sima W, Brien WW. Ipsilateral fractures of the femoral neck and shaft. J Orthop Trauma. 1992;6:159–66.
Gadegone WM, Salphale YS. Proximal femoral nail-an analysis of 100 cases of proximal femoral fractures with an average follow up of 1 year. Int Orthop. 2007;31:403-8.
Barquet A, Femandez A, Leon H. Simultaneous ipsilateraltrochenteric and femoral shaft fracture. Acta Orthop Scand. 1985;56:36–9.
Russell TA. Ipsilateral femoral neck and shaft fractures. Clin Orthop Relat Res. 1986;208:188–94.
Winquist RA, Hansen ST, Clawson DK. Closed intramedullary nailing of femoral fractures. A report of five hundred and twenty cases. J Bone Joint Surg (Am). 1984;66:529-39.
Boulton CL, Pollak AN. Special topic: ipsilateral femoral neck and shaft fractures- does evidence give us the answer? Injury. 2015;46:478-83.
Alho A. Concurrent ipsilateral fractures of the hip and femoral shaft. A meta-analysis of 659 cases. Acta Orthop Scand. 1996;67:19-28.
Bucholz RN, Rathjen K. Concomitant Ipsilateral fractures of the hip and femur treated with interlocking nails. Orthopaedics. 1985;8:1402-6
Gibbons CL, Gregg-Smith SJ, Carrell TW, Murray DW, Simpson AH. Use of the Russell-Taylor reconstruction nail in femoral shaft fractures. Injury. 1995;26:389-92.
Bose WJ, Corces A, Anderson LD. A preliminary experience with the Russel Taylor reconstruction nail for complex femoral fractures. J Trauma. 1992;32:71–6.
Randelli P, Landi S, Fanton F, Hoover GK, Morandi M. Treatment of ipsilateral femoral neck and shaft fractures with the Russell-Taylor reconstructive nail. Orthopedics. 1999;22:673-6.
Hossam EM, Adel MH, Emad EY. Ipsilateral fracture of the femoral neck and shaft, treatment by reconstruction interlocking nail. Arch Orthop Trauma Surg. 2001;121:71- 4.
Jain P, Maini L, Mishra P, Upadhyay A, Agarwal A. Cephalomedullary interlocked nail for ipsilateral hip and femoral shaft fractures. Injury. 2004;35:1031-8.
Oh CW, Oh JK, Park BC, Jeon IH, Kyung HS, Kim SY, et al. Retrograde nailing with subsequent screw fixation for ipsilateral femoral shaft and neck fractures. Arch Orthop Trauma Surg. 2006;126:448–53.
Abalo A, Dossim A, OuroBangna AF, Tomta K, Assiobo A, Walla A. Dynamic hip screw and compression plate fixation of ipsilateral femoral neck and shaft fractures. J Orthop Surg. 2008;16:35
Douša P, Bartoníek J, Pavelka T, Lunácek L. Ipsilateral fractures of the proximal femur and the femoral shaft. Acta Chir Orthop Traumatol Cech. 2010;77:378–88.
Pavleka T, Lihart M, Matejka J, Vyskocil V. Osteosynthesis of ipsilateral hip and femoral shaft fracture with a long PFN. Zentralbl Chir. 2005;130:148-52.
Chen CH, Chen TB, Cheng YM, Chang JK, Lin SY, Hung SH. Ipsilateral fractures of the femoral neck and shaft. Injury. 2000;31:719–22.
