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Title of Journal: Arch Orthop Trauma Surg

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Abbravation: Archives of Orthopaedic and Trauma Surgery

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Springer-Verlag

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DOI

10.1016/0740-0020(86)90002-x

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1434-3916

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Antegrade nailing of femoral shaft fractures combi

Authors: Güvenir Okcu Kemal Aktuglu
Publish Date: 2003/09/09
Volume: 123, Issue: 10, Pages: 544-550
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Abstract

Fifteen patients with ipsilateral femoral neck and shaft fractures group 1 and 10 patients with ipsilateral femoral shaft and distal femur fractures group 2 were treated from 1990 to 1998 Highenergy injuries occurred in all patients There were 4 open fractures Antegrade locked nailing of diaphyseal fractures was performed in all cases Supplemental screws for the neck were used in all patients in group 1 and in 3 patients in group 2All of the fractures united during the followup Five patients in group 1 underwent reoperation 333 one due to a delayed union the second due to an implant failure the third due to a nonunion of a neck fracture and the last two because of an initially missed femoral neck fracture None of the patients in group 2 underwent reoperation Angular malalignment of the shaft was found in 6 fractures in group 1 average 48o range 3o–11o and in 4 fractures in group 2 average 6o range 3o–12o Shortening of the limb occurred in 3 patients in group 1 average 14 cm range 1–18 and in 1 patient in group 2 2 cm Loss of fixation was seen in 1 patient in each group Avascular necrosis and infection were not seen in any case in both groupsFemoral intramedullary nails with antegrade or retrograde options for insertion and different locking possibilities have extended the indications to include both diaphyseal and metaphyseal fractures New nail designs usually more expensive than the conventional nails have been introduced into the market for this purpose One has to keep in mind that antegrade locked nailing of femoral shaft fractures combined with neck or distal femur fractures is a technically demanding but efficacious procedure The success rate is high when the technique is meticulously implemented

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