Background: Concomitant ipsilateral femoral shaft and neck fractures present a challenge to the
orthopaedic surgeon, and no consensus has yet emerged on the optimal treatment method. We report
the results of a retrospective study of 43 patients with these complex fractures who were treated at a
single Level 1 trauma centre.
Patients and methods: The study participants consisted of 28 males and 15 females with a mean age of 43
years. The mean follow-up period was 48 months. Four different treatment methods were used: (1)
antegrade reamed intramedullary nailing of the shaft with cancellous screw fixation of the neck, (2)
dynamic hip screw (DHS) fixation of the neck and low-contact dynamic compression plate (LCDCP)
fixation of the shaft, (3) cancellous screw fixation of the neck and LCDCP fixation of the shaft, and (4)
reconstruction nailing of both shaft and neck.
Results: No statistically significant differences in amount of blood loss, duration of surgery, total
complication rate, nor clinical results were found among the four treatment methods. For femoral neck
fracture, however, the complication rate of cannulated screw with antegrade intramedullary nailing
fixation was 11 times that of DHS with LCDCP fixation.
Conclusions: Antegrade nail with screw fixation is not a recommended treatment method in patients
with ipsilateral femoral shaft and neck fractures.
關聯:
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED 40(7):778~782
