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Ipsilateral femoral neck and shaft fractures: a retrospective analysis of two treatment methods

BACKGROUND: No consensus exists regarding the optimal treatment of ipsilateral femoral neck and shaft fractures. The three major issues related to these fractures are the optimal timing of surgery, which fracture to stabilize first, and the optimal implant to use. In an effort to find answers to the...

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Autores principales: Singh, Roop, Rohilla, Rajesh, Magu, Narender Kumar, Siwach, Ramchander, Kadian, Virender, Sangwan, Sukhbir Singh
Formato: Texto
Lenguaje:English
Publicado: Springer Milan 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2656981/
https://www.ncbi.nlm.nih.gov/pubmed/19384610
http://dx.doi.org/10.1007/s10195-008-0025-3
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author Singh, Roop
Rohilla, Rajesh
Magu, Narender Kumar
Siwach, Ramchander
Kadian, Virender
Sangwan, Sukhbir Singh
author_facet Singh, Roop
Rohilla, Rajesh
Magu, Narender Kumar
Siwach, Ramchander
Kadian, Virender
Sangwan, Sukhbir Singh
author_sort Singh, Roop
collection PubMed
description BACKGROUND: No consensus exists regarding the optimal treatment of ipsilateral femoral neck and shaft fractures. The three major issues related to these fractures are the optimal timing of surgery, which fracture to stabilize first, and the optimal implant to use. In an effort to find answers to these three key issues, we report our experience of managing 27 patients with ipsilateral femoral neck and shaft fractures by using two different treatment methods, i.e., reconstruction-type intramedullary nailing and various plate combinations. MATERIALS AND METHODS: We divided patients into two groups. Group I included 15 patients (13 males and 2 females) who were operated with cancellous lag screws or dynamic hip screws (DHS) for fractured neck and compression plate fixation for fractured shaft of the femur. Group II included 12 patients (11 males and 1 female) who were operated with reconstruction-type intramedullary nailing. RESULTS: Mean age was 33.2 and 37.9 years in group I and II, respectively. Mean delay in surgery was 5.9 and 5.4 days in group I and II, respectively. Average union time for femoral neck fracture in groups I and II were 15.2 and 17.1 weeks, respectively; and for shaft fracture these times were 20.3 and 22.8 weeks, respectively. There were 13 (86.6%) good, 1 (6.7%) fair and 1 (6.7%) poor functional results in group I. There were 10 (83.3%) good, 1 (8.3%) fair and 1 (8.3%) poor functional results in group II. CONCLUSIONS: Both of the treatment methods used in the present study achieved satisfactory functional outcome in these complex fractures. Fixation with plate for shaft and screws or DHS for hip is easy from a technical point of view. Choice of the treatment method should be dictated primarily by the type of femoral neck fracture and the surgeon’s familiarity with the treatment method chosen. The femoral neck fracture should preferably be stabilized first, and a delay of 5–6 days does not affect the ultimate functional outcome.
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spelling pubmed-26569812009-03-25 Ipsilateral femoral neck and shaft fractures: a retrospective analysis of two treatment methods Singh, Roop Rohilla, Rajesh Magu, Narender Kumar Siwach, Ramchander Kadian, Virender Sangwan, Sukhbir Singh J Orthop Traumatol Original Article BACKGROUND: No consensus exists regarding the optimal treatment of ipsilateral femoral neck and shaft fractures. The three major issues related to these fractures are the optimal timing of surgery, which fracture to stabilize first, and the optimal implant to use. In an effort to find answers to these three key issues, we report our experience of managing 27 patients with ipsilateral femoral neck and shaft fractures by using two different treatment methods, i.e., reconstruction-type intramedullary nailing and various plate combinations. MATERIALS AND METHODS: We divided patients into two groups. Group I included 15 patients (13 males and 2 females) who were operated with cancellous lag screws or dynamic hip screws (DHS) for fractured neck and compression plate fixation for fractured shaft of the femur. Group II included 12 patients (11 males and 1 female) who were operated with reconstruction-type intramedullary nailing. RESULTS: Mean age was 33.2 and 37.9 years in group I and II, respectively. Mean delay in surgery was 5.9 and 5.4 days in group I and II, respectively. Average union time for femoral neck fracture in groups I and II were 15.2 and 17.1 weeks, respectively; and for shaft fracture these times were 20.3 and 22.8 weeks, respectively. There were 13 (86.6%) good, 1 (6.7%) fair and 1 (6.7%) poor functional results in group I. There were 10 (83.3%) good, 1 (8.3%) fair and 1 (8.3%) poor functional results in group II. CONCLUSIONS: Both of the treatment methods used in the present study achieved satisfactory functional outcome in these complex fractures. Fixation with plate for shaft and screws or DHS for hip is easy from a technical point of view. Choice of the treatment method should be dictated primarily by the type of femoral neck fracture and the surgeon’s familiarity with the treatment method chosen. The femoral neck fracture should preferably be stabilized first, and a delay of 5–6 days does not affect the ultimate functional outcome. Springer Milan 2008-08-07 2008-09 /pmc/articles/PMC2656981/ /pubmed/19384610 http://dx.doi.org/10.1007/s10195-008-0025-3 Text en © Springer-Verlag 2008
spellingShingle Original Article
Singh, Roop
Rohilla, Rajesh
Magu, Narender Kumar
Siwach, Ramchander
Kadian, Virender
Sangwan, Sukhbir Singh
Ipsilateral femoral neck and shaft fractures: a retrospective analysis of two treatment methods
title Ipsilateral femoral neck and shaft fractures: a retrospective analysis of two treatment methods
title_full Ipsilateral femoral neck and shaft fractures: a retrospective analysis of two treatment methods
title_fullStr Ipsilateral femoral neck and shaft fractures: a retrospective analysis of two treatment methods
title_full_unstemmed Ipsilateral femoral neck and shaft fractures: a retrospective analysis of two treatment methods
title_short Ipsilateral femoral neck and shaft fractures: a retrospective analysis of two treatment methods
title_sort ipsilateral femoral neck and shaft fractures: a retrospective analysis of two treatment methods
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2656981/
https://www.ncbi.nlm.nih.gov/pubmed/19384610
http://dx.doi.org/10.1007/s10195-008-0025-3
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