A comparison of intramedullary nailing and plate-screw fixation in the treatment for ipsilateral fracture of the hip and femoral shaft

Abstract

We compared the outcomes of intramedullary nailing with plate-screw fixation in the treatment for ipsilateral fracture of the hip and femoral shaft. A retrospective study. Level 1 Trauma. Forty-one patients (32 males and 9 females; mean age, 34 years; age range, 21-53) with ipsilateral hip and femoral shaft fractures were treated between 1995 and 2005. Eighteen patients were injured in motor vehicle accidents, and 23 fell from a height. All patients were treated by one of the two methods of internal fixation: a screw-plate fixation (n = 24, Group I) or intramedullary nailing (n = 17, Group II). The fracture union time, nonunion, delayed union, implant failure, need of further surgeries, and functional outcomes were investigated and compared. Fisher's exact test showed that Group I had a significantly higher frequency of nonunion than that of Group II (P = 0.029). Although Group I had more nonunions, delayed unions, and revision operations than Group II, the total union time was similar for both groups. Intramedullary nailing was found to be superior to screw-plate fixation due to improved functional bearing, increased rate of union, stability, and mechanical solidity. The reconstruction nail method is an acceptable alternative treatment for ipsilateral hip and femoral shaft fractures.

Application of fracture-sustaining reduction frame in closed reduction of femoral shaft fracture

“…Due to well-developed thigh muscles, there would be many malposition and overlapping after fracture. Due to the stretch of the muscle, the fracture would always be in severe malposition, which is difficult for reduction, and most adults suffer from femoral shaft fracture, requiring surgical treatment [1, 2]. At present, it is a common clinical belief that closed reduction intramedullary nail insertion is the gold standard for the closed reduction of femoral shaft fractures [3], while the realization of rapid closed reduction during an operation remains a challenge for orthopedic physicians.…”

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

“…Though recent literature shows favourable results with the use of a single implant i.e., reconstruction type of intramedullary nail, we are of the opinion that treating these combination of fractures with two separate devices (plate-screw combinations) does have a role. [7][8][9][10][11][12][13][14][15] In this study we compared the outcome of ipsilateral hip and shaft femur fractures treated with reconstruction-type intramedullary nailing and various plate combinations on the fracture healing and functional outcome in patients. Very few authors have compared these two methods of fixation.…”

“…Very few authors have compared these two methods of fixation. 13,14 Femoral neck fracture is unrecognized in the initial examination of 19-31% of patients.…”

“…[7][8][9][10][11][12][13][14][15]  Various plate-screw combinations-including a dynamic hip screw (DHS) and long side plate combination, a hip screw with a short side plate for the neck and separate plate for the shaft or cancellous screws for femoral neck and a plate for the shaft. 13,14,16  Retrograde intramedullary nail of the shaft and screw fixation of the neck. [17][18][19]  Antegrade femoral nailing of the shaft with separate screws adjacent to the nail for fixation of neck ('miss-a-nail' technique).…”

Improve the Efficiency of Surgery for Femoral Shaft Fractures with A Novel Instrument: A Randomized Controlled Trial

“…Options for the treatment of femoral fractures have become increasingly available, and have been proven effective. In recent years, closed reduction and interlocking intramedullary nail internal fixation has become the standard treatment for femoral shaft fractures[ 1 – 5 ]. During the operation, 2 issues affect the operative process and time.…”