Treatment of Ipsilateral Basicervical Femoral Neck and Shaft Fractures with Cephalomedullary Nail (PFNA-II): Report of Two Cases and Review of Literature

Abstract

Ipsilateral femoral neck and shaft fractures are rare types of fractures. Most surgeons have recommended fixation with two separate prostheses because the use of a single cephallomedullary device often results in higher rates of complication and malunion. Proximal femoral nail antirotation was designed initially for the fixation of peritrochanteric fractures while the second generation nail was introduced specifically to accommodate the femoral size and geometry of Asians. The application of the less-invasive, firstgeneration antirotation nail in the fixation of ipsilateral femoral neck and shaft fractures among Asians has resulted in similar outcome compared to the use of two separate prostheses; however, studies of the second-generation antirotation nail in the fixation of the aforementioned fractures have been insufficient. We present two patients with ipsilateral femoral neck and shaft fractures treated with the second-generation antirotation nail. After months of follow up, radiographs revealed proper alignment and complete union of the fractures. The patients were ambulatory with nearly full ranges of motion. We therefore conclude that reduction and fixation with the second-generation antirotation nail results in good functional result and satisfactory outcome.