J Korean Fract Soc.  2009 Oct;22(4):225-231. 10.12671/jkfs.2009.22.4.225.

Limited Open Reduction and Intramedullary Nailing of Proximal Femoral Shaft Fracture

• Ha SH
• Lee JY
• Lee SH
• Jo SH
• Yu JC

• KMID: 1469987
• DOI: http://doi.org/10.12671/jkfs.2009.22.4.225

Abstract

PURPOSE
To evaluate the result of treatment of proximal femoral shaft fracture with limited open reduction and intramedullary nailing. MATERIALS AND METHODS: Fifteen patients who had limited open reduction and intramedullary nailing due to proximal femoral shaft fracture for follow-up for more than 12 months were selected between March 2001 and December 2005. The clinical and radiologic results were analyzed. Winquist-Hansen classification and OTA/AO classification were used. RESULTS: Thirteen cases achieved bone union and 2 cases showed delayed union. The mean bone union period was 21.3 weeks (14~32). There was no postoperative infection. Nonunion was observed in 2 cases of which bone union was acquired with the exchange of intramedullary nail and bone graft in one case and with the additional plate fixation and bone graft in the other case. CONCLUSION: Treating proximal femoral shaft fracture with limited open reduction and intramedullary nailing seems to be a technique to manage proximal femoral shaft fracture that has combined fracture or ipsilateral femoral fracture or is unable to acquire acceptable reduction with closed reduction.

Keyword

Femur; Proximal shaft fracture; Limited open reduction; Interlocked intramedullary nailing

MeSH Terms

Femoral Fractures
Femur
Follow-Up Studies
Fracture Fixation, Intramedullary
Humans
Nails
Transplants

Figure

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  Fig. 1 (A, B) A 43-year-old male sustained Winquist-Hansen type I, OTA/AO type B1 fracture of the left proximal femur. (C, D) The patient was treated with limited open reduction and intramedullary nailing. (E, F) Intraoperative limited open reduction with bone holder is shown. (G, H) Radiographs taken 14 months postoperatively shows complete healing of the fracture.

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  Fig. 2 (A) A 49-year-old male sustained Winquist-Hansen type IV, OTA/AO type C1 fracture of the right femur. (B) The patient was treated with limited open reduction, intramedullary nailing and cerclage wiring. (C) Radiograph taken 8 months postoperatively shows nonunion of the fracture. (D) Radiograph taken 9 months postoperatively shows additional plate fixation and bone graft on the proximal fracture site.

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  Fig. 3 (A) A 47-year-old male sustained Winquist-Hansen type IV, OTA/AO type C1 fracture of the right femur. (B) The patient was treated with limited open reduction and intramedullary nailing. (C) Radiograph taken 4 months postoperatively shows callus on the proximal fracture site. (D) Radiograph taken 15 months postoperatively shows complete healing of the fracture and mild varus angulation.

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