JSH Lin, CW Lo, SC Cheng, MY Kuo, LS Chin
Orthopaedic Department, Chi-Mei Foundation Medical Center, 901 Junghua Road, Yungkang City, Tainan, Taiwan

PURPOSE. Owing to unpredictable femoral neck reduction, reconstruction nails are not suitable for fixation of group 3 ipsilateral femoral neck-shaft fractures. We developed a new one-step fixation technique to overcome this problem. This study aims to assess this new technique at the Orthopaedic
Department, Chi-Mei Foundation Medical Center, Tainan.

METHODS. Of 31 consecutive patients with femoral fractures treated by reconstruction nails, five patients had group 3 ipsilateral femoral neck-shaft fractures, 4 of whom were treated by a new surgical technique. Two 5.0-mm drills were firstly inserted to tether the trochanter fragment, and distal locking screws were secondly applied to immobilise the shaft fracture. The neck-shaft angle was then restored in a closed fashion and proximal cephalomedullary screws were attached. Patients were followed up by post-operative radiography.

RESULTS. All 5 cases of group 3 ipsilateral femoral neckshaft fracture obtained radiographic union without significant surgical sequelae. Three of the patients had implants removed. No patients presented with osteonecrosis at the 3-year follow-up.

CONCLUSION. The new approach to manage ipsilateral femoral neck-shaft fractures by using reconstruction nails obtains relatively good clinical results.

Key words: ipsilateral femoral neck-shaft fractures; reconstruction nails