J Korean Fract Soc.  2015 Jan;28(1):23-29. 10.12671/jkfs.2015.28.1.23.

Treatment for Concurrent Ipsilateral Femoral Neck and Shaft Fractures Using Reconstruction Nail with Temporary K-Wires

• Lee SJ
• Lee SH
• Ha SH
• Lee GC

• KMID: 1774093
• DOI: http://doi.org/10.12671/jkfs.2015.28.1.23

Abstract

PURPOSE
The purpose of this study is to evaluate the results of operative treatment using a reconstruction nail after temporary K-wire fixation of the femoral neck for ipsilateral femoral neck and shaft fractures.
MATERIALS AND METHODS
A total of 11 cases were treated, which were followed-up for more than two years, between August 2007 and July 2012. The average age was 51 years (29-69 years) and men were dominant counting eight cases. All cases were operated with a reconstruction nail after temporary K-wire fixation of the femoral neck. Bone union periods, alignment, etc. were evaluated by radiological methods and accompanying damage and complications were also investigated. Functional evaluation was performed in accordance with Friedman and Wyman criteria at the last follow-up.
RESULTS
The average time for union of the femoral shaft was 22.5 weeks (12-32 weeks), and femoral neck was 13.1 weeks (8-20 weeks). There was no nonunion, and four femoral shaft fractures resulted in delayed union. There was one case of leg length discrepancy more than 2 cm long, but malalignment of more than 10 degrees was not observed. Avascular necrosis of the femoral head did not occur. Functional results were good in eight cases, fair in two cases, and poor in one case.
CONCLUSION
Treatment with reconstruction nailing after temporary K-wire fixation of the femoral neck is thought to be a good method which prevents neck displacement and has low complication rates.

Keyword

Femoral shaft; Femoral neck; Temporary K-wire; Reconstruction nail

MeSH Terms

Femur Neck*
Follow-Up Studies
Head
Humans
Leg
Male
Neck
Necrosis

Figure

• 

  Fig. 1 (A) The entry point of the reconstruction nail lies transversely in the extension of the axis of the medullary canal, directly lateral to the tip of the greater trochanter (dot and arrow). We made a portal on the slight anterolateral of the original entry portal (circle). Temporary K-wire fixation was anterior to posterior of the femoral neck (black line). (B, C) C-arm image of the operation.

• 

  Fig. 2 (A, B) These X-rays show an ipsilateral femoral neck and shaft fracture in a 57-year-old female. (C, D) Immediate postoperative femoral radiographs after application of a Sirus® femoral nail. (E, F) Femur anteroposterior and lateral radiographs taken 6 months after the operation show complete bone union. (G) Leg length discrepancy developed.

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