Sang Ho Ha; Jun Young Lee; Sang Hong Lee; Sung Hwan Jo; Jae Cheul Yu

doi:10.12671/jkfs.2009.22.4.225

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Original Article
Limited Open Reduction and Intramedullary Nailing of Proximal Femoral Shaft Fracture: Sang Ho Ha, M.D., Jun Young Lee, M.D., Sang Hong Lee, M.D., Sung Hwan Jo, M.D., Jae Cheul Yu, M.D.; Journal of the Korean Fracture Society 2009;22(4):225-231.
DOI: https://doi.org/10.12671/jkfs.2009.22.4.225
Published online: October 30, 2009

Department of Orthopaedic Surgery, College of Medicine, Chosun University, Gwangju, Korea.

Address reprint requests to: Jun-Young Lee, M.D. Department of Orthopaedic Surgery, Chosun University Hospital, 588, Seosuk-dong, Dong-gu, Gwangju 501-717, Korea. Tel: 82-62-220-3147, Fax: 82-62-226-3379, leejy88@chosun.ac.kr

• Received: February 6, 2009 • Revised: June 5, 2009 • Accepted: July 21, 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
To evaluate the result of treatment of proximal femoral shaft fracture with limited open reduction and intramedullary nailing.
Materials and Methods
Fifteen patients who had limited open reduction and intramedullary nailing due to proximal femoral shaft fracture for follow-up for more than 12 months were selected between March 2001 and December 2005. The clinical and radiologic results were analyzed. Winquist-Hansen classification and OTA/AO classification were used.
Results
Thirteen cases achieved bone union and 2 cases showed delayed union. The mean bone union period was 21.3 weeks (14~32). There was no postoperative infection. Nonunion was observed in 2 cases of which bone union was acquired with the exchange of intramedullary nail and bone graft in one case and with the additional plate fixation and bone graft in the other case.
Conclusion
Treating proximal femoral shaft fracture with limited open reduction and intramedullary nailing seems to be a technique to manage proximal femoral shaft fracture that has combined fracture or ipsilateral femoral fracture or is unable to acquire acceptable reduction with closed reduction.
Key words: Femur, Proximal shaft fracture, Limited open reduction, Interlocked intramedullary nailing

REFERENCES

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Fig. 1

(A, B) A 43-year-old male sustained Winquist-Hansen type I, OTA/AO type B1 fracture of the left proximal femur.

(C, D) The patient was treated with limited open reduction and intramedullary nailing.

(E, F) Intraoperative limited open reduction with bone holder is shown.

(G, H) Radiographs taken 14 months postoperatively shows complete healing of the fracture.

Fig. 2

(A) A 49-year-old male sustained Winquist-Hansen type IV, OTA/AO type C1 fracture of the right femur.

(B) The patient was treated with limited open reduction, intramedullary nailing and cerclage wiring.

(C) Radiograph taken 8 months postoperatively shows nonunion of the fracture.

(D) Radiograph taken 9 months postoperatively shows additional plate fixation and bone graft on the proximal fracture site.

Fig. 3

(A) A 47-year-old male sustained Winquist-Hansen type IV, OTA/AO type C1 fracture of the right femur.

(B) The patient was treated with limited open reduction and intramedullary nailing.

(C) Radiograph taken 4 months postoperatively shows callus on the proximal fracture site.

(D) Radiograph taken 15 months postoperatively shows complete healing of the fracture and mild varus angulation.

Table 1

Demographics of patients treated with limited open reduction and intramedullary nailing of proximal femoral shaft fracture

^*W-H: Winquist and Hansen classification of fracture comminution, ^†MVA: Motor vehicle accident.

Figure & Data

REFERENCES

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Limited Open Reduction and Intramedullary Nailing of Proximal Femoral Shaft Fracture

J Korean Fract Soc. 2009;22(4):225-231. Published online October 31, 2009

DOI: https://doi.org/10.12671/jkfs.2009.22.4.225

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Limited Open Reduction and Intramedullary Nailing of Proximal Femoral Shaft Fracture

Fig. 1 (A, B) A 43-year-old male sustained Winquist-Hansen type I, OTA/AO type B1 fracture of the left proximal femur. (C, D) The patient was treated with limited open reduction and intramedullary nailing. (E, F) Intraoperative limited open reduction with bone holder is shown. (G, H) Radiographs taken 14 months postoperatively shows complete healing of the fracture.

Fig. 2 (A) A 49-year-old male sustained Winquist-Hansen type IV, OTA/AO type C1 fracture of the right femur. (B) The patient was treated with limited open reduction, intramedullary nailing and cerclage wiring. (C) Radiograph taken 8 months postoperatively shows nonunion of the fracture. (D) Radiograph taken 9 months postoperatively shows additional plate fixation and bone graft on the proximal fracture site.

Fig. 3 (A) A 47-year-old male sustained Winquist-Hansen type IV, OTA/AO type C1 fracture of the right femur. (B) The patient was treated with limited open reduction and intramedullary nailing. (C) Radiograph taken 4 months postoperatively shows callus on the proximal fracture site. (D) Radiograph taken 15 months postoperatively shows complete healing of the fracture and mild varus angulation.

Fig. 1

Fig. 2

Fig. 3

Limited Open Reduction and Intramedullary Nailing of Proximal Femoral Shaft Fracture

Table 1

Demographics of patients treated with limited open reduction and intramedullary nailing of proximal femoral shaft fracture

^*W-H: Winquist and Hansen classification of fracture comminution, ^†MVA: Motor vehicle accident.

Table 1 Demographics of patients treated with limited open reduction and intramedullary nailing of proximal femoral shaft fracture

^*W-H: Winquist and Hansen classification of fracture comminution, ^†MVA: Motor vehicle accident.