Role of reconstruction intramedullary nailing in the treatment of ipsilateral femoral neck and shaft fractures

Abstract

Background: Ipsilateral femoral neck and shaft fractures are an uncommon injury, and many a times, femoral neck fracture is missed initially making treatment of these fractures a challenge to the treating surgeon. Still controversy exists regarding which technique and implant provide optimal treatment of these complex injuries. The purpose of this study was to evaluate the results of ipsilateral femoral neck and shaft fractures treated with reconstruction intramedullary nailing. Materials and Methods: Eighteen patients having ipsilateral femoral neck and shaft fractures were included in this study. One patient was having bilateral involvement. All the patients were treated by close reduction and internal fixation with reconstruction intramedullary nailing. Average follow-up period was 3.5 years (range 2–8 years). Results: According to Friedman–Wayman criteria, the outcome was good in 14 (77.8%), fair in 3 (16.7%), and poor in 1 (5.5%) patient. Femoral shaft fracture in one patient who was having bilateral involvement went into nonunion which required revision nailing with antegrade femoral interlocking nail. Conclusion: The treatment of these injuries with reconstruction intramedullary nailing is advantageous in terms of possible close antegrade nailing with minimal surgical trauma, reduced blood loss, less incidence of infection, and biological fixation of both fractures with a single implant.