Analysis of the results of ipsilateral hip and shaft femur fractures treated with reconstruction nail

Abstract

Background : Ipsilateral fractures of hip and shaft femur are a complex problem. High rate of complications are inherent with this injury. To choose from wide variety operative techniques and hardware available makes a life further difficult for an average orthopedic surgeon. Method : We present a series of 25 cases with ipsilateral hip and shaft femur fractures treated by intramedullary reconstruction nail. Intraoperative complications and postoperative results were critically analyzed. Results : Difficulty in reduction was observed in thirteen patients, improper placement of cervical screws in eleven patients and there was postoperative distraction present at fracture site in seven patients. Seven patients had malunion at hip and three at shaft femur. Nonunion was present in three patients with fracture shaft femur and one patient with fracture neck of femur requiring secondary surgical procedures. Conclusion : Though reconstruction nail is a good option for undisplaced or minimally displaced fractures at hip. In patients with marked displacement and comminution at fracture site its results are good only in experienced hands and needs further evaluation. Experience of the surgeon in managing these kinds of complex injuries cannot be over emphasized.