Journal of Musculoskeletal Trauma

Comparison of Operative Methods between Retrograde and Antegrade Nailing for Ipsilateral Femoral Shaft and Neck Fracture: Chang Wug Oh, Jong Keon Oh, Woo Kie Min, Shin Yoon Kim, Seung Hoon Baek, Byung Chul Park, Hyung Soo Ahn, Tae Gong Kim; J Korean Fract Soc 2007;20(2):135-140. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.135

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

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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Bilateral Femoral Neck Fractures in a Young Adult: A Case Report: Eea Sub Chung, Jae Kyu Park; J Korean Fract Soc 2005;18(4):478-480. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.478

Abstract PDF: Ipsilateral femur shaft and neck fractures are occurred by high energy trauma, usually in motor vehicle accidents or fall from a height. Simultaneous Ipsilateral femur shaft and neck fractures and contralateral femur neck fracture are not yet reported in Korea. Authors report a case of simultaneous bilateral femoral neck fractures combined with a ipsilateral femoral shaft fracture in a young adult treated with anatomical reduction, internal fixation and vascularized bone graft with a review of the literature.

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Treatment of Ipsilateral Femoral Neck and Shaft Fractures: Jung Ryul Kim, Hyung Suk Lee, Myung Sik Park, Hee Chul Yu, Doo Hyun Yang; J Korean Soc Fract 2003;16(3):327-333. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.327

Abstract PDF: PURPOSE
To analyse the result of the treatment of ipsilateral femoral neck and shaft fractures and to consider effective method of the treatment.
MATERIALS AND METHODS
Seventeen patients with ipsilateral femoral neck and shaft fractures were treated from January 1992 to January 1999 and followed up more than 2 years. Radiologic bony union between each treatment method, complication were analysed. The functional results assessed with Iowa hip rating system and Swiontkowski system.
RESULTS
In femoral neck fractures, bony union was obtained in all cases, average 12 weeks. In femoral shaft fractures, bony union was obtained in all but one case. There was no statistical association bony union time between each treatment method (p>0.05). By Iowa hip rating system, nine hips had an excellent result; eight, a good result. According to rating system of Swiontkowski, the result was excellent in nine, good in six, fair in one, and poor in one.
CONCLUSION
We concluded that early diagnosis of all injuries was needed. To avoid further vascular damage of femoral head, early anatomical reduction of the femoral neck fracture should be performed. And then, shaft fracture was fixed with implants which were most appropriate for that combination of fractures.

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Treatment of Ipsilateral Femur Neck & Shaft Fracture: Jin Woo Kwon, Ki Hwon Kim, Sang Ho Moon, Kyu Min Kong, Kyong Tae Sohn, Sang Hoon Lee, Tae Woo Kwon; J Korean Soc Fract 2003;16(3):319-326. Published online July 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.3.319

Abstract PDF: PURPOSE
The purpose of this study was to analyse the result of operative treatment in ipsilateral femur neck and shaft fracture.
MATERIALS AND METHODS
Eleven cases of ipsilateral femur neck and shaft fractures were operated and followed more than 1 year. There were 11 men and the mean age at index operation was 38 years (range 22~54). In neck fracture there were 3 of type I, 6 of type II, and 1 of type III according to Garden classification, shaft fractures were located at middle 1/3(7 cases), at distal 1/3(4 cases). We evaluate the operation time, union time, nonunion, malunion, and clinical evaluation with pain and joint stiffness.
RESULTS
In neck fractures treatment methods were 8 of multiple pinning, 2 of reconstruction nail and 1 of CHS, in shaft fractures 2 of DCP, 7 of retrograde nailing (3 Ender nail, 4 interlocking nail). The mean operation time was 180 minutes in reconstruction nail, 220 minutes in multiple pinning and DCP and 200 minutes in multiple pinning and retrograde nailing. The mean time for shaft union was 5 months. The complications were 1 case of neck reduction loss during operation in reconstruction nailing group, 2 of aseptic necrosis of femur head, 2 of shaft nonunion in retrograde nailing group, 1 of persistant pain around knee in Ender nailing group.
CONCLUSION
The author think that reconstruction nail fixation is technically difficult, thus neck and shaft fracture be fixed individually. Neck fracture can be fixed first without difficulty and shaft fracture should be fixed rigidly due to comminution.

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Ipsilateral Femoral Neck and Shaft Fracture: Secondary Avascular Necrosis of Femoral Head: Sung Taek Jung, Keun Bae Lee, Taek Lim Yoon, Sang Don Shim, Myung Seon Kim; J Korean Soc Fract 2001;14(4):609-615. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.609

Abstract PDF: PURPOSE
To evaluate the prognostic variables that influence the incidence of complication such as avascular necrosis of femoral head, nonunion of neck after the treatment of ipsilateral femoral neck and shaft fracture by the results and long term follow up. MATERIAL AND METHODS: We studied the 18 cases of 17 patients that could be follow up over 2 years among the patients received the treatment of ipsilateral femoral neck and shaft fracture from 1987 to 1998. The average follow up duration was 54.3 months (24-120) and all patients was men. The average age was 38.2 yrs(20-60). Fifteen cases of femoral neck fracture were treated with multiple pinning and 3 cases with the compression hip screw, 12 cases of femoral shaft fracture were treated with DCP, 5 cases by interlocking IM nailing and 1 case, open fracture, by external fixator. We evaluated the bone union and complication such as avascular necrosis of femoral head and nonunion.
RESULTS
For femoral neck fracture, resection arthroplasty was performed in 1 case and nonunion in 1 case. Bone union was obtained at average 4 months in 16 cases of femoral neck fracture, at 9 months in all cases of shaft fracture. The avascular necrosis of femoral head in 5 cases included 1 case of nonunion was found at minimal 20 months to maximal 59 months follows up.
DISCUSSION
All prognostic variables of the ipsilateral femoral neck and shaft fracture, that is the Garden stage, Pauwels classification, delayed time to operation. had no statistical correlation with complication. Whenever possible the patients should be followed for a minimum 5 years to rule out avascular necrosis of femoral head.

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Difficulties in the treatment for ipsilateral concomitent femoral neck & shaft fractures: Chang Wug Oh, Shin Yoon Kim, Hee Soo Kyung, Joo Chul Ihn, Hyung Tae So, Jong Min Lee, Ho Wook Wee; J Korean Soc Fract 2001;14(2):152-158. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.152

Abstract PDF

PURPOSE
This retrospective study was performed to know the difficulties and efficient methods of treatment after several types of operations for ipsilateral femoral neck and shaft fracture.
MATERIALS AND METHODS
Thirteen cases (12 patients) with ipsilateral femoral neck and shaft fracture at the mean age of 36.6(range 21-51), have been followed up over the minimum of one year. All the patients suffered from motor vehicle accidents(11 in dash-board injury), and most of patients associated with multiple injuries including other fractures. All of femoral neck fracture were same type in basicervical area and 4 of them were missed initially. According to the classification of femoral shaft fractures, middle 1/3 fracture was most common in 10 cases and type C in 8 cases. In neck fractures, all cases were treated with multiple pinning, but in shaft fractures, 6 were treated by open plating, 5 by closed antegrade nailing, and 2 by retrograde nailing.
RESULTS
The mean union period was 12.1 weeks in neck fractures and 9.9 months in shaft fractures. In complications, there were 1 case of nonunion and 1 case of avascular necrosis in neck fractures, and 8 of delayed union, 3 of nonunion, and 2 of malunion, in shaft fractures. The methods of treatment had no influence on the results of this injury, but we had 1 failure in antegrade nailing prior to operation of neck fracture.
CONCLUSION
After operation of ipsilateral femoral neck and shaft fracture, the shaft fracture needed longer time of union and had many problems in spite of different methods. We suppose that many problems in shaft are affected not only by characteristic mechanism of injury, but also by multiple associated injury.

Citations

Citations to this article as recorded by

Treatment for Concurrent Ipsilateral Femoral Neck and Shaft Fractures Using Reconstruction Nail with Temporary K-Wires
Sang-Joon Lee, Sang Hong Lee, Sang Ho Ha, Gwang-Chul Lee
Journal of the Korean Fracture Society.2015; 28(1): 23. CrossRef
Comparison of Operative Methods between Retrograde and Antegrade Nailing for Ipsilateral Femoral Shaft and Neck Fracture
Chang-Wug Oh, Jong-Keon Oh, Woo-Kie Min, Shin-Yoon Kim, Seung-Hoon Baek, Byung-Chul Park, Hyung-Soo Ahn, Tae-Gong Kim
Journal of the Korean Fracture Society.2007; 20(2): 135. CrossRef
Retrograde Intramedullary Nailing for the Treatment of Ipsilateral Femoral Shaft and Neck Fracture
Chang-Wug Oh, Jong-Keon Oh, Shin-Yoon Kim, Ki-Bong Cha, In-Ho Jeon, Byung-Chul Park, Woo-Kie Min, Tae-Gong Kim
The Journal of the Korean Orthopaedic Association.2007; 42(3): 380. CrossRef

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Ipsilateral Fractures of Femoral neck and Shaft: Byeong Hwan Kim, Sung Keun Sohn, Soo Jin Park; J Korean Soc Fract 1999;12(1):13-20. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.13

Abstract PDF: Ipsilateral fractures of the femoral neck and shaft are uncommon injuries with the difficulties in diagnosis and treatment. The femoral neck fracture of this injury is commonly missed on initial evaluation. The overlooked femoral neck fracture may lead to higher risk of complications such as avascular necrosis of the femoral head, nonunion and coxa vara. The authors reviewed nine cases of ipsilateral femoral neck and shaft fracture treated in our clinic from June 1990 to March 1997, and average follow-up period was 39 months(range, 16 to 97 months). The results obtained were as follows ; 1. The cause of injury was traffic accident and one femoral neck fracture was missed initially. 2. The most common site of femoral neck fracture was basicervical in 7 cases and that of shaft fractures was middle 1/3 shaft in 6 cases. 3. Two cases were treated with femoral reconstruction nail, seven with multiple neck pinning and dynamic compression plate for shaft fracture. 4. There were complication such as 2 cases of delayed union of femoral shaft, 1 case of nonunion of femoral shaft. 5. It should be treated with anatomical and rigid internal fixation in femoral neck fracture having first priority.

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Ipsilateral Fracture of the Femoral Neck and Shaft: Chong Kwan Kim, Jeong Hwan Kim, Dae Young Kim; J Korean Soc Fract 1998;11(4):738-744. Published online October 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.4.738

Abstract PDF: Ipsilateral femoral neck and shaft fractures are uncommon and have difficulty in diagnosis. The injury results from high energy trauma. From January, 1990 to March, 1995, 10 cases of ipsilateral femur neck and shaft fractures had been treated. Follow up period varied from 10 months to 3 years (average 1 year 10 month). The purpose of this study is to evaluate the fracture pattern of neck, complications due to delayed operation, and efficient methods of fixation. The neck fractures were minimally displaced or not displaced in 8 cases. The femur shaft fractures were usually comminuted and located at midshaft. The timing of operation was often determined by the patient's status as a multiple trauma victim, but a delay of days to cases, diagnosis was delayed, but there was no complication, like as avascular necrosis and nonunion. There was one case of nonunion of femur shaft, and which was treated with bone graft. We could not find the difference in complication rate among the fixation methods. Anatomic reduction and stable fixation seem to be more important than the method of fixation and timing of operation.

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Fracture around Hip Joint Combined with Ipsilateral Femoral Shaft Fracture: Sung Kwan Whang, Jung Ho Rha, Jin Rok Oh, Young Hyun Park; J Korean Soc Fract 1997;10(4):746-754. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.746

Abstract PDF: Fracture around hip joint combined with ipsilateral femoral shaft fracture is relatively uncommon injury and usually result from high-energy trauma. In many of cases, this fracture accompanies with multiple fractures and may be unrecognized the fracture around hip joint. The mechanism of this fracture is that the force on knee joint breaks femoral shaft, and then, when adductive position of femoral shaft, the remained force dislocates hip joint or breaks acetabulum, when abductive position of the shaft, the force breaks femoral neck or intertrochanter. The treatment methods of this fracture are many, but there is no choice of treatment. So, when we select method of treatment, we must consider patients all situations(patients age, pattern of fracture, qulality of bone, ability of surgeon, etc.). The purpose of this study is to make the algorithim of the selection of treatment method for rracture around hip joint combined with ipsilateral femoral shaft fracture. We reviewed 37 cases of fracture around hip joint combined with iplilateral femoral shaft fracture from Febrary 1978 to June 1996. The minimal follow-up period was 1 year. From the review, we made the algorithm of the selection of treatment method for fracture around hip joint combined with ipsilaterl femoral shaft fracture.

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Ipsilateral Fracture of the Femoral Neck and Shaft: Ho Jung Kang, Dae Yong Han, Dong Eun Shin; J Korean Soc Fract 1994;7(2):246-255. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.246

Abstract PDF: Ipsilateral fractures of the femoral neck and shaft are relatively uncommon infuries and usually the result of high-energy trauma in young adults. Frequently, the severe trauma responsible for this injury combination is also productive of associated injuries indeed life threatening. Several unique features of this injury have been recognized, including the high incidence of associated knee injuries, particulary fractures of the patella. This is thought to be due to a mechanism of injury in which the femur is longitudinally loaded at the flexed knee while positioned in neutral abduction. Also, this combination of injuries pose a difficult problem in management. The authors reviewed 14 cases of ipsilateral fracture of the femoral neck and shaft for the evaluation of the associated injury and method of ueatment from October 1986 to Febraury 1991 and the average follow-up period was 1.8 years. The results were as follows. 1. The site of the femoral neck and shaft fracture were mainly, basicervical and midshaft. 2. In two cases, the femoral neck fracture was not diagnosed initially. 3. Most of the associated fractures were patella and tibial fractures and PCL ruptures. 4. Complications Included three stiffness of the knee, two delayed union of the femoral shaft, one superficial wound infection and one delayed union with coxa vara deformity of the femoral neck.

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