Journal of Musculoskeletal Trauma

Comparison of Operative Methods between Retrograde and Antegrade Nailing for Ipsilateral Femoral Shaft and Neck Fracture: Chang Wug Oh, Jong Keon Oh, Woo Kie Min, Shin Yoon Kim, Seung Hoon Baek, Byung Chul Park, Hyung Soo Ahn, Tae Gong Kim; J Korean Fract Soc 2007;20(2):135-140. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.135

PURPOSE
To compare retrospectively the antegrade and retrograde nailing in the management of ipsilateral femoral neck and shaft fractures.
MATERIALS AND METHODS
Thirty-two patients (thirty-three injuries) were included in this study. Mean age of patients was 38 years-old in the antegrade nailing group (16 injuries) and 44 years-old in the retrograde nailing group (17 injuries). We compared the union of fractures and complications between two groups, and investigated the influencing factors.
RESULTS
Femoral shaft fracture was united in 10 cases (63%) of antegrade group and 12 cases (71%) of retrograde group, at 28.2 and 27.3 weeks respectively. Nonunion was more prevalent in Winquist-Hansen III and IV (5 in antegrade nailing, 3 in retrograde nailing) than I and II. Femoral neck fracture was united with 1 case of nonunion in each group. Nonunion developed from Garden stage IV, but fractures of Garden stage I and II united regardless of methods.
CONCLUSION
In ipsilateral femoral neck and shaft fractures, the kinds of methods did not affect the results of shaft fractures. Minimally displaced neck fractures also were not influenced by kinds of methods, but retrograde nailing may have a benefit in fixing the displaced neck fractures

Citations

Citations to this article as recorded by

Surgical management of bifocal femoral fractures: a systematic review and pooled analysis of treatment with a single implant versus double implants
J. D. Cnossen, Esther M. M. Van Lieshout, Michael H. J. Verhofstad
Archives of Orthopaedic and Trauma Surgery.2023; 143(10): 6229. CrossRef
Retrograde Intramedullary Nailing or the Treatment of Segmental Femoral Shaft Fracture Including Distal Part
Jong-Ho Yoon, Byung-Woo Ahn, Chong-Kwan Kim, Jin-Woo Jin, Ji-Hoon Lee, Hyun-Ku Cho, Joo-Hyun Lee
Journal of the Korean Fracture Society.2009; 22(3): 145. CrossRef
The Treatment of IM Nailing of Femoral Shaft Fracture: Piriformis Fossa versus Trochanteric Entry Portal
Hyun Kook Youn, Oog Jin Shon, Dong Sung Han
Journal of the Korean Fracture Society.2008; 21(3): 200. CrossRef

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Ipsilateral Femoral Neck and Shaft Fracture: Secondary Avascular Necrosis of Femoral Head: Sung Taek Jung, Keun Bae Lee, Taek Lim Yoon, Sang Don Shim, Myung Seon Kim; J Korean Soc Fract 2001;14(4):609-615. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.609

Abstract PDF: PURPOSE
To evaluate the prognostic variables that influence the incidence of complication such as avascular necrosis of femoral head, nonunion of neck after the treatment of ipsilateral femoral neck and shaft fracture by the results and long term follow up. MATERIAL AND METHODS: We studied the 18 cases of 17 patients that could be follow up over 2 years among the patients received the treatment of ipsilateral femoral neck and shaft fracture from 1987 to 1998. The average follow up duration was 54.3 months (24-120) and all patients was men. The average age was 38.2 yrs(20-60). Fifteen cases of femoral neck fracture were treated with multiple pinning and 3 cases with the compression hip screw, 12 cases of femoral shaft fracture were treated with DCP, 5 cases by interlocking IM nailing and 1 case, open fracture, by external fixator. We evaluated the bone union and complication such as avascular necrosis of femoral head and nonunion.
RESULTS
For femoral neck fracture, resection arthroplasty was performed in 1 case and nonunion in 1 case. Bone union was obtained at average 4 months in 16 cases of femoral neck fracture, at 9 months in all cases of shaft fracture. The avascular necrosis of femoral head in 5 cases included 1 case of nonunion was found at minimal 20 months to maximal 59 months follows up.
DISCUSSION
All prognostic variables of the ipsilateral femoral neck and shaft fracture, that is the Garden stage, Pauwels classification, delayed time to operation. had no statistical correlation with complication. Whenever possible the patients should be followed for a minimum 5 years to rule out avascular necrosis of femoral head.

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Ipsilateral Fracture of the Femoral Neck and Shaft: Ho Jung Kang, Dae Yong Han, Dong Eun Shin; J Korean Soc Fract 1994;7(2):246-255. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.246

Abstract PDF: Ipsilateral fractures of the femoral neck and shaft are relatively uncommon infuries and usually the result of high-energy trauma in young adults. Frequently, the severe trauma responsible for this injury combination is also productive of associated injuries indeed life threatening. Several unique features of this injury have been recognized, including the high incidence of associated knee injuries, particulary fractures of the patella. This is thought to be due to a mechanism of injury in which the femur is longitudinally loaded at the flexed knee while positioned in neutral abduction. Also, this combination of injuries pose a difficult problem in management. The authors reviewed 14 cases of ipsilateral fracture of the femoral neck and shaft for the evaluation of the associated injury and method of ueatment from October 1986 to Febraury 1991 and the average follow-up period was 1.8 years. The results were as follows. 1. The site of the femoral neck and shaft fracture were mainly, basicervical and midshaft. 2. In two cases, the femoral neck fracture was not diagnosed initially. 3. Most of the associated fractures were patella and tibial fractures and PCL ruptures. 4. Complications Included three stiffness of the knee, two delayed union of the femoral shaft, one superficial wound infection and one delayed union with coxa vara deformity of the femoral neck.

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