Treatment for ipsilateral fractures of femoral neck and shaft

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Title:	Treatment for ipsilateral fractures of femoral neck and shaft
Authors:	蔡俊灝(Chun-Hao Tsai);許弘昌(Horng-Chaung Hsu);馮逸卿(Yi-Chin Fong)*;林承志(Cheng-Jyh Lin);陳英豪(Ying-Hao Chen);許晉榮(Chin-Jung Hsu)
Contributors:	中國附醫骨科部
Keywords:	Trauma;Orthopaedics;Ipsilateral;Femoral shaft fracture;Femoral neck fracture
Date:	2009-06
Issue Date:	2009-08-20 17:31:46 (UTC+8)
Abstract:	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.
Relation:	INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED 40(7):778~782
Appears in Collections:	[China Medical University Hospital] Jurnal articles

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