Publication:

Analysis of the results of ipsilateral hip and shaft femur fractures treated with reconstruction-type intramedullary nail or various plate combinations

Background Ipsilateral femoral shaft and hip fractures are commonly encountered following high energy trauma. Despite many treatment methods, controversy exists regarding the optimal management of these fractures. This study was planned to compare reconstruction-type intramedullary nailing and various plate combinations on the fracture healing and functional outcome in patients with these fractures.

Methods 25 patients with ipsilateral femoral shaft and hip fractures were operated by one of the  two modalities - cancellous lag screws or dynamic hip screw for fracture hip and compression plate fixation for fracture shaft of the femur (Group I, 13 patients) and Reconstruction-type intramedullary nailing  alone (Group II, 12 patients) -  depending on surgeon's preference. The functional results of the patients were assessed with the system used by Friedman and Wyman. Radiological and functional assessment was done by an independent evaluator blinded to the surgical procedure.

Results The mean age was 33.6±4.03 in group I and 35.3±4.04 years in group II (p=0.70). The average follow up was 15 months. The average union time for femoral neck fracture was 15.75±0.89 and 16.48±1.40 (p=0.36) weeks and for fracture shaft was 19.27±1.18 and 20.06±1.16 (p=0.15) in group I and group II respectively. 10 patients (76.9%) in group I and 9 (75%) in group II showed good functional results. Two patients needed re-operation in group I and one patient in group II.

Conclusions Ipsilateral femoral shaft and hip fractures can be treated satisfactorily either with nailing alone or various plate combinations with similar outcome.