Retrograde Intramedullary Nailing for the Treatment of Ipsilateral Femoral Shaft and Neck Fracture / 대한정형외과학회잡지

ABSTRACT

PURPOSE: To evaluate the results of the operative method for ipsilateral femoral shaft and neck fractures using retrograde nailing technique. MATERIALS AND METHODS: Seventeen fractures (sixteen patients), followed-up more than 1 year, were included in this study. There were 14 men and 2 women, and the mean age was 44 years-old. According to the Winquist-Hansen classification, type II was most common with 11 cases. In femoral neck fractures, type B was most common with 13 cases according to AO-OTA classification and 6 of them were type II in Garden stage. After retrograde nailing of femoral shaft fractures, neck fractures were fixed by cannulated screw or dynamic hip screw. RESULTS: The average time for union of shaft fractures was 27.3 (14-60) weeks. Nonunion occurred in five patients, who required bone grafts or changes of fixation. The average time for union of neck fractures was 11 (8-12) weeks. All united, except for one case of nonunion with avascuar necrosis, which was a Garden stage IV fracture. Functional results using Friedman-Wyman criteria were good in 16 cases, and fair in one. The only fair result was nonunion of the femoral neck, which had the joint arthroplasty. CONCLUSION: Although the union rate of femoral shaft must be improved, retrograde nailing can provide an easy fixation and a favorable result for ipsilateral femoral neck fractures.