Treatment of Ipsilateral Femur Neck & Shaft Fracture

Kwon, Jin Woo; Kim, Ki Hwon; Moon, Sang Ho; Kong, Kyu Min; Sohn, Kyong Tae; Lee, Sang Hoon; Kwon, Tae Woo

Abstract

PURPOSE: The purpose of this study was to analyse the result of operative treatment in ipsilateral femur neck and shaft fracture.
MATERIALS AND METHODS
Eleven cases of ipsilateral femur neck and shaft fractures were operated and followed more than 1 year. There were 11 men and the mean age at index operation was 38 years (range 22~54). In neck fracture there were 3 of type I, 6 of type II, and 1 of type III according to Garden classification, shaft fractures were located at middle 1/3(7 cases), at distal 1/3(4 cases). We evaluate the operation time, union time, nonunion, malunion, and clinical evaluation with pain and joint stiffness.
RESULTS
In neck fractures treatment methods were 8 of multiple pinning, 2 of reconstruction nail and 1 of CHS, in shaft fractures 2 of DCP, 7 of retrograde nailing (3 Ender nail, 4 interlocking nail). The mean operation time was 180 minutes in reconstruction nail, 220 minutes in multiple pinning and DCP and 200 minutes in multiple pinning and retrograde nailing. The mean time for shaft union was 5 months. The complications were 1 case of neck reduction loss during operation in reconstruction nailing group, 2 of aseptic necrosis of femur head, 2 of shaft nonunion in retrograde nailing group, 1 of persistant pain around knee in Ender nailing group.
CONCLUSION
The author think that reconstruction nail fixation is technically difficult, thus neck and shaft fracture be fixed individually. Neck fracture can be fixed first without difficulty and shaft fracture should be fixed rigidly due to comminution.