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Original Article
Comparison of Operative Methods between Retrograde and Antegrade Nailing for Ipsilateral Femoral Shaft and Neck Fracture
Chang-Wug Oh, M.D., Jong-Keon Oh, M.D., Woo-Kie Min, M.D., Shin-Yoon Kim, M.D., Seung-Hoon Baek, M.D., Byung-Chul Park, M.D., Hyung-Soo Ahn, M.D., Tae-Gong Kim, M.D.
Journal of the Korean Fracture Society 2007;20(2):135-140.
DOI: https://doi.org/10.12671/jkfs.2007.20.2.135
Published online: June 14, 2016

Department of Orthopedic Surgery, School of Medicine, Kyungpook National University, School of Medicine, Seoul, Korea.

*Department of Orthopedic Surgery, School of Medicine, Korea University, Seoul, Korea.

**Department of Anatomy, School of Medicine, Kyungpook Natiorial University, Daegu, Korea.

Address reprint requests to: Chang-Wug Oh, M.D. Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, 101, Dongin-dong 2-ga, Jung-gu, Deagu 700-422, Korea. Tel: 82-53-420-5630, Fax: 82-53-422-6605, cwoh@knu.ac.kr

Copyright © The Korean Fracture Society. All rights reserved

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  • 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
  • 1. Alho A. Concurrent ipsilateral fractures of the hip and femoral shaft. a meta-analysis of 659 cases. Acta Orthop Scand, 1996;67:19-28.Article
  • 2. Casey MJ, Chapman MW. Ipsilateral concomitant fractures of the hip and femoral shaft. J Bone Joint Surg Am, 1979;61:503-509.Article
  • 3. Chen CH, Chen TB, Cheng YM, Chang JK, Lin SY, Hung SH. Ipsilateral fractures of the femoral neck and shaft. Injury, 2000;31:719-722.Article
  • 4. Friedman RJ, Wyman ET Jr. Ipsilateral hip and femoral shaft fractures. Clin Orthop Relat Res, 1986;208:188-194.Article
  • 5. Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am, 1976;58:453-458.
  • 6. Hansen ST, Winquist RA. Closed intramedullary nailing of the femur. Kuntscher technique with reaming. Clin Orthop Relat Res, 1979;138:56-61.
  • 7. Jain P, Maini L, Mishra P, Upadhyay A, Agarwal A. Cephalomedullary interlocked nail for ipsilateral hip and femoral shaft fractures. Injury, 2004;35:1031-1038.Article
  • 8. Kim SJ, Oh CW, Ihn JC, Kim HS, Jeon IH, Kyung HS. Retrograde intramedullary nail for femoral shaft fracture with limited indications. J Korean Soc Fract, 2003;16:45-51.Article
  • 9. Leung KS, So WS, Lam TP, Leung PC. Treatment of ipsilateral femoral shaft fractures and hip fractures. Injury, 1993;24:41-45.Article
  • 10. Oh CW, Kim SY, Kyung HS, Ihn JC, So HT, Lee JM. Difficulties in the treatment for ipsilateral concomitent femoral neck & shaft fractures. J Korean Soc Fract, 2001;14:152-158.Article
  • 11. Orthopaedic Trauma, and Classification. Fracture and dislocation compendium. J Orthop Trauma, 1996;10:1-154.
  • 12. Patterson BM, Routt ML Jr, Benirschke SK, Hansen ST Jr. Retrograde nailing of femoral shaft fractures. J Trauma, 1995;38:38-43.Article
  • 13. Randelli P, Landi S, Fanton F, Hoover GK, Morandi M. Treatment of ipsilateral femoral neck and shaft fractures with the Russell-Taylor reconstructive nail. Orthopedics, 1999;22:673-676.
  • 14. Swiontkowski MF, Hansen ST Jr, Kellam J. Ipsilateral fractures of the femoral neck and shaft. A treatment protocol. J Bone Joint Surg, 1984;66:260-268.Article
  • 15. Watson JT, Moed BR. Ipsilateral femoral neck and shaft fractures: complications and their treatment. Clin Orthop Relat Res, 2002;399:78-86.
  • 16. Wiss DA, Sima W, Brien WW. Ipsilateral fractures of the femoral neck and shaft. J Orthop Trauma, 1992;6:159-166.Article
  • 17. Wolinsky PR, Johnson KD. Ipsilateral femoral neck and shaft fractures. Clin Orthop Relat Res, 1995;318:81-90.
  • 18. Wu CC, Shih CH. Ipsilateral femoral neck and shaft fractures. Retrospective study of 33 cases. Acta Orthop Scand, 1991;62:346-351.Article
  • 19. Yang KH, Han DY, Park HW, Kang HJ, Park JH. Fracture of the ipsilateral neck of the femur in shaft nailing. The role of CT in diagnosis. J Bone Joint Surg Br, 1998;80:673-678.Article
Fig. 1

(A) A 29-year-male with femur shaft fracture.

(B) Postoperatively, femur neck fracture was found on the radiograph (arrow) and CT image.
(C) Fourteen days after initial operation, fixation was done with three screws anterior to the femoral nail.
jkfs-20-135-g001.jpg
Fig. 2

(A) At 2 month, femoral neck fracture healed and callus is forming on the shaft fracture.

(B) At 6 month, all fractures healed uneventfully without leg length discrepancy.
jkfs-20-135-g002.jpg
Fig. 3

(A) A 61-year-man with ipsilateral fractures of femoral shaft and neck.

(B) Retrograde nailing of the shaft and screw fixation of the neck was done.
jkfs-20-135-g003.jpg
Fig. 4

At 5 month, fractures healed uneventfully.

jkfs-20-135-g004.jpg
Fig. 5

(A) 24 years old female with femur shaft fracture and ipsilateral displaced neck fracture.

(B) Antegrade nailing and screw fixation of the neck was done. Due to the preinserted nail, there were some difficulties in screw fixation.
jkfs-20-135-g005.jpg
Fig. 6

(A) At 3 months after surgery, the neck fracture displaced with loosening of the screws.

(B) Using dynamic hip screw and dynamic compression plate, revision procedure was done on both fractures.
(C) At 7 month after 2nd operation, both fractures healed.
jkfs-20-135-g006.jpg

Figure & Data

REFERENCES

    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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      Comparison of Operative Methods between Retrograde and Antegrade Nailing for Ipsilateral Femoral Shaft and Neck Fracture
      J Korean Fract Soc. 2007;20(2):135-140.   Published online April 30, 2007
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    Comparison of Operative Methods between Retrograde and Antegrade Nailing for Ipsilateral Femoral Shaft and Neck Fracture
    Image Image Image Image Image Image
    Fig. 1 (A) A 29-year-male with femur shaft fracture. (B) Postoperatively, femur neck fracture was found on the radiograph (arrow) and CT image. (C) Fourteen days after initial operation, fixation was done with three screws anterior to the femoral nail.
    Fig. 2 (A) At 2 month, femoral neck fracture healed and callus is forming on the shaft fracture. (B) At 6 month, all fractures healed uneventfully without leg length discrepancy.
    Fig. 3 (A) A 61-year-man with ipsilateral fractures of femoral shaft and neck. (B) Retrograde nailing of the shaft and screw fixation of the neck was done.
    Fig. 4 At 5 month, fractures healed uneventfully.
    Fig. 5 (A) 24 years old female with femur shaft fracture and ipsilateral displaced neck fracture. (B) Antegrade nailing and screw fixation of the neck was done. Due to the preinserted nail, there were some difficulties in screw fixation.
    Fig. 6 (A) At 3 months after surgery, the neck fracture displaced with loosening of the screws. (B) Using dynamic hip screw and dynamic compression plate, revision procedure was done on both fractures. (C) At 7 month after 2nd operation, both fractures healed.
    Comparison of Operative Methods between Retrograde and Antegrade Nailing for Ipsilateral Femoral Shaft and Neck Fracture

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