Ipsilateral femoral neck and shaft fractures are rare. These combined injuries are much more challenging to treat than either a femoral neck or shaft fracture alone and often require modification of the routine neck or shaft fracture treatment methods. In this study, we used long Gamma3 compressing interlocking nails ((long Gamma3 nail, Stryker, America, http://www.stryker.com/en-us/glp/index.htm). With a supplementary cross-cannulated screw (diameter 7.3 mm, Osteomed, America, www.osteomed.com) to stabilize the combined fractures, which is a novel technique. The supplementary cannulated screw was inserted from the anterior edge of the greater trochanter and was then orientated perpendicular to the femoral neck fracture line to increase the compression between the fracture edges. From October 2012 to January 2016, 11 patients with ipsilateral femoral shaft and neck fractures were treated using this technique at our hospital. One patient was lost to follow-up. A total of 10 patients were followed up at 6-week intervals for at least one year (range, 12-24 months; average, 18 months). All femoral neck fractures healed in an average of 13.2 weeks, ranging from 12 to 18 weeks). The average time to union for the femoral shaft fractures was 22.2 weeks, ranging from 18 to 24 months. There were no cases of nonunion or avascular necrosis of the femoral head. Our technique provides a new option for treating these combined fractures. Long Gamma3 compressing interlocking nails with a supplementary cross-cannulated screw, in the mid-term, yielded acceptable clinical and functional results. The procedures of the technique are simple and decrease the operating time. Further investigation should be performed to compare the methods with all currently available surgical options in large, multicenter trials.
[1]Jilin Univ, Dept Orthoped, Hosp 1, Changchun 130021, Peoples R China.
[2]Jilin Univ, Hosp 1, Dept Neurosurg, Changchun 130021, Peoples R China.
(8.0+极速模式)