Reconstruction nailing for ipsilateral femoral neck and shaft fractures

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

The surgical management of ipsilateral fractures of the femoral neck and shaft presents a difficult and challenging problem for the orthopaedic surgeon. The purpose of the present study was to report the mid-term results and complications in a series of patients who sustained ipsilateral femoral neck and shaft fractures and treated in our trauma department with a single reconstruction nail for both fractures. Eleven patients were included in the study with an average age of 46.4 years. The mean follow-up was 47 months (range, 15–75 months). There were no cases of a missed diagnosis at initial presentation. The mean time to union was 4.5 months for the neck fracture and 8.2 months for the shaft. There were no cases of avascular necrosis of the femoral head or non-union of the neck fracture. The mean Harris Hip Score was (85 ± 4.3). Complications included two cases of shaft fracture non-union and one case of peroneal nerve palsy. Heterotopic ossification at the tip of the greater trochanter was evident in two cases without causing any functional deficit. The current study suggests that reconstruction nailing produces satisfactory clinical and functional results in the mid-term. The complications involved only the femoral shaft fracture and were successfully treated with a single operative procedure.

Related collections

Most cited references 24

Record: found
Abstract: found
Article: not found

Operative treatment of femoral neck fractures in patients between the ages of fifteen and fifty years.

George J Haidukewych, Walter S Rothwell, David J Jacofsky … (2004)

There is a paucity of data on the treatment of femoral neck fractures in young patients. The purpose of the present study was to review the results and complications associated with the treatment of femoral neck fractures with internal fixation in a large consecutive series of young patients. Between 1975 and 2000, eighty-three femoral neck fractures in eighty-two consecutive patients who were between fifteen and fifty years old were treated with internal fixation at our institution. Two patients died, and eight were lost to follow-up. Seventy-three fractures were followed until union, until conversion to hip arthroplasty, or for a minimum of two years; the mean duration of follow-up was 6.6 years. Fifty-one of the seventy-three fractures were displaced, and twenty-two were nondisplaced. The results and complications of treatment were retrospectively reviewed, and the effects of fracture displacement, reduction quality, and capsular decompression on outcome were evaluated. Function was assessed by evaluating pain, walking capacity, and the need for gait aids. The mean duration of follow-up for the fifty-seven patients (fifty-eight fractures) who had not undergone early conversion to arthroplasty was 8.1 years. Fifty-three (73%) of the seventy-three fractures healed after one operation and were associated with no evidence of osteonecrosis of the femoral head. Osteonecrosis developed in association with seventeen fractures (23%), and a nonunion developed in association with six (8%). Four of the six nonunions later healed after a secondary procedure. At the time of the final follow-up, thirteen patients had had a conversion to a total hip arthroplasty because of osteonecrosis (eleven), nonunion (one), or both (one). Five (9.8%) of the fifty-one displaced fractures were associated with the development of nonunion, and fourteen (27%) were associated with the development of osteonecrosis. Three (14%) of the twenty-two nondisplaced fractures were associated with the development of osteonecrosis, and one (4.5%) was associated with the development of nonunion. Eleven (24%) of the forty-six displaced fractures with a good to excellent reduction were associated with the development of osteonecrosis, and two (4%) were associated with the development of nonunion. Four of the five displaced fractures with a fair or poor reduction were associated with the development of osteonecrosis, nonunion, or both. The ten-year survival rate of the native femoral head free of conversion to total hip arthroplasty was 85%. Osteonecrosis was the main reason for conversion to total hip arthroplasty, but not all patients with osteonecrosis required further surgery. The results of treatment were influenced by fracture displacement and the quality of reduction.

0 comments Cited 102 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Acceleration of tibial fracture-healing by non-invasive, low-intensity pulsed ultrasound.

J D Heckman, J P Ryaby, J McCabe … (1994)

Sixty-seven closed or grade-I open fractures of the tibial shaft were examined in a prospective, randomized, double-blind evaluation of use of a new ultrasound stimulating device as an adjunct to conventional treatment with a cast. Thirty-three fractures were treated with the active device and thirty-four, with a placebo control device. At the end of the treatment, there was a statistically significant decrease in the time to clinical healing (86 +/- 5.8 days in the active-treatment group compared with 114 +/- 10.4 days in the control group) (p = 0.01) and also a significant decrease in the time to over-all (clinical and radiographic) healing (96 +/- 4.9 days in the active-treatment group compared with 154 +/- 13.7 days in the control group) (p = 0.0001). The patients' compliance with the use of the device was excellent, and there were no serious complications related to its use. This study confirms earlier animal and clinical studies that demonstrated the efficacy of low-intensity ultrasound stimulation in the acceleration of the normal fracture-repair process.

0 comments Cited 62 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Comminuted fractures of the femoral shaft treated by intramedullary nailing.

T Hansen, R Winquist (1980)

We evaluated 245 cases of comminuted femoral fractures treated by intramedullary nailing and graded them by fracture pattern and degree of stability as segmental fractures, and grade I, grade II, grade III, and grade IV comminuted fractures. The infection rate was 0.4 per cent, and the nonunion rate was 0.8 per cent. Shortening of more than 2 cm. was seen in seven cases (3 per cent), and malrotation of more than 20 degrees was noted in four cases (1.7 per cent). These more common problems of shortening and rotation were almost eliminated by the increased use of cerclage wire and postoperative traction and spica casts. Knee range of motion averaged 128 degrees. These fractures provide interesting and difficult challenges. Intramedullary nailing of the segmental fractures is technically demanding but offers excellent results in these otherwise difficult fractures. Patients with grade I and grade II comminuted fractures do well with intramedullary nailing and the bones remain stable. Grade III and grade IV comminuted fractures are unstable and pose the risk of shortening and rotation. Therefore, to gain anatomic restoration in a young person we believe that it is reasonable to perform an open reduction and cerclage wiring of these fractures. The postoperative treatment of the comminuted femoral fracture is determined by both fracture stability and patient reliability, and frequent roentgenograms are indicated. Most importantly, the surgeon should be prepared to apply whatever form of treatment he believes to be necessary to gain optimal results in each individual.

0 comments Cited 27 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

: +30 2410-553751 , +30-2410-682719 , +30-2410-670107 , hantesmi@otenet.gr

Journal

Journal ID (nlm-ta): Strategies Trauma Limb Reconstr

Title: Strategies in Trauma and Limb Reconstruction

Publisher: Springer Milan (Milan )

ISSN (Print): 1828-8936

ISSN (Electronic): 1828-8928

Publication date (Electronic): 21 July 2011

Publication date PMC-release: 21 July 2011

Publication date (Print): August 2011

Volume: 6

Issue: 2

Pages: 69-75

Affiliations

The Department of Orthopaedic Surgery, University Hospital of Larissa, School of Health Sciences, University of Thessalia, Mezourlo, 41110 Larissa, Greece

Article

Publisher ID: 117

DOI: 10.1007/s11751-011-0117-0

PMC ID: 3150652

PubMed ID: 21779894

SO-VID: f1ce6b91-dfc9-4b8d-97d3-208cf9039777

History

Date received : 10 July 2010

Date accepted : 11 July 2011

Custom metadata

ScienceOpen disciplines: Emergency medicine & Trauma

Keywords: femoral shaft fractures,ipsilateral hip,reconstruction nail

Data availability:

ScienceOpen disciplines: Emergency medicine & Trauma

Keywords: femoral shaft fractures, ipsilateral hip, reconstruction nail

Comments

Comment on this article

scite_

Smart Citations

Citing PublicationsSupportingMentioningContrasting

View Citations

See how this article has been cited at scite.ai

scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.