Outcomes of Ipsilateral Femoral Neck and Shaft Fractures Treated With Proximal Femoral Nail Antirotation 2.

Rajesh Rana,Himansu Behera,Sudarsan Behera,Madho Singh,Amrit G

doi:10.7759/cureus.18511

Abstract

Ipsilateral femoral neck and shaft fractures are relatively rare fractures, which most commonly occur in young adults following high-energy trauma. In most cases of such fractures, neck fracture is undisplaced and often of basicervical type. Many treatment methods have been described, but there is still no generalized consensus on the same. Cephalomedullary nails are one of the preferred modalities of treatment. A cephalomedullary nail-like proximal femoral nail antirotation 2 (PFNA 2) of recent design is being widely used currently. In this study, we present 13 cases of ipsilateral femoral neck and shaft fractures treated with PFNA 2 implants. The advantages of the PFNA 2 system include reduced blood loss, reduced operative time, and fewer fluoroscopy shots. PFNA 2 is a biomechanically better implant than many cephalomedullary implants. It provides satisfactory results in ipsilateral femoral neck and shaft fractures, especially where neck fracture is of a basicervical type. Some aspects have to be taken care of when employing PFNA 2, such as anatomical reduction, and length, angulation, and rotation of both neck and shaft.

Highlights

Ipsilateral femoral neck and shaft fractures are rare entities, and they mainly occur due to high-velocity trauma [1,2]
We present 13 cases of ipsilateral femoral neck and shaft fractures treated with proximal femoral nail antirotation 2 (PFNA 2) implants
Iatrogenic femoral neck fractures sustained while doing femoral shaft fracture nailing cases, patients treated with another type of cephalomedullary nails, and compound fractures of the femur were excluded

Summary

Introduction

Ipsilateral femoral neck and shaft fractures are rare entities, and they mainly occur due to high-velocity trauma [1,2]. The shaft of femur fractures are generally comminuted and displaced, whereas neck fractures are usually basicervical and undisplaced in 60% of the cases [5]. This indicates that most of the energy is absorbed by a femur shaft [3]. These injuries have been on the rise with the increase in high-velocity trauma cases. Neck femur fracture carries the risk of complications due to delays in surgery, such as an increased chance of avascular necrosis (AVN) in the long term [6]

Methods

Discussion

Conclusion