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EXPERIENCE WITH THE CEPHALOMEDULLARY INTERLOCKING NAIL FOR IPSILATERAL HIP AND FEMORAL SHAFT FRACTURES



Abstract

Twenty one cases of ipsilateral hip and femoral shaft fractures, between January 1998 and December 2001, managed by reconstruction nail were reviewed. All patients underwent simultaneous surgery for both fractures and operative treatment was executed as early as general condition of the patient permitted. Delay in treatment was generally because of associated injuries [head, chest or abdominal]. There were 20 males and 1female patients with an average age of 34.5 years. There was delayed diagnosis of neck fracture in 2 cases and these cases were not included in the study.

Our average follow-up is 30.9 months. There was one case of nonunion of a femoral neck fracture, one case of avascular necrosis and one neck fracture that united in varus. There were 4 nonunions and 6 cases of delayed union of femoral shaft fractures. Mean time for union of femoral neck fracture was 15 weeks and for shaft fracture was 22 weeks. In our results, shaft fracture determined the total union period. Though complications involving the femoral shaft fracture were greater than the femoral neck fractures, the shaft complications were more manageable compared to neck complications. This stresses the need to realize the significance and seriousness of both components of this complex injury, in evaluation, management and postoperative care.

Conclusion: Though technically demanding the reconstruction nail is an optimal alternative for management of concomitant fracture of femoral neck and shaft with low rates of complications and good results.

The abstracts were prepared by Mr Tim Briggs. (Editoral Secretary 2003/4) Correspondence should be addressed to him at Lane Farm, Chapel Lane, Totternhoe, Dunstable, Bedfordshire LU6 2BZ, United Kingdom