Ipsilateral proximal and shaft femoral fractures treated with bridge-link type combined fixation system
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(2020) 15:399
RESEARCH ARTICLE
Open Access
Ipsilateral proximal and shaft femoral fractures treated with bridge-link type combined fixation system Liangqi Kang1, Hui Liu1, Zhenqi Ding1, Yiqiang Ding2, Wei Hu2 and Jin Wu1*
Abstract Background: Although many treatments for ipsilateral proximal and shaft femoral fractures have been developed, controversy exists regarding their optimal management. The purpose of this retrospective study was to discuss the effectiveness of the bridge-link type combined fixation system (BCFS) and evaluate functional outcomes in treating patients with these complex fractures. Patients and methods: We retrospectively reviewed 14 cases of ipsilateral proximal and shaft femoral fractures treated from January 2012 to December 2016. All cases were treated by BCFS combined with minimally invasive percutaneous plate osteosynthesis (MIPPO). Clinical and radiographic data were collected during regular post-operative follow-up visits. Functional outcomes were determined according to the Friedman and Wyman scoring system. Results: The proximal femoral fractures were emergency diagnoses in 11 cases and delayed diagnoses in 3 cases. The delay time was 5–6 days, with an average of 5.3 days. The mean operation time was 179.6 min (range 135–231 min) with a blood loss volume that ranged from 430 to 535 ml (average 483.6 ml). Follow-up was conducted in 13 cases between 9 and 30 months post-operation, with an average follow-up time of 17.3 months. The proximal femoral fractures were united in 12 cases at the final follow-up. One case had nonunion 13 months after the operation, underwent valgus intertrochanteric osteotomy, and healed 6 months later. The femoral shaft fractures obtained rigid union at the latest follow-up in 12 cases. One case endured nonunion 12 months after the operation. After the revision surgery and iliac bone grafting, the fracture healed 6 months later. Eight of the cases had good functional results, 4 had fair results, and results were poor in 1 case at the final follow-up. Conclusions: The treatment of ipsilateral proximal femoral and shaft fractures with BCFS in combination with MIPPO demonstrated a high likelihood of union for both fractures and good functional results. Keywords: Femoral shaft fractures, Femoral proximal fractures, Bridge-link type combined fixation system (BCFS), MIPPO
Introduction The first case report of an ipsilateral proximal and shaft femoral fracture was published in 1953 [1]. Since then, orthopedists have paid more attention to this combined injury pattern and provided recommendations regarding * Correspondence: [email protected] 1 Department of Orthopedics, The Affiliated Southeast Hospital of Xiamen University, Zhangzhou 363000, China Full list of author information is available at the end of the article
its diagnosis and treatment. Ipsilateral proximal and shaft femoral fracture presentation is rare, accounting for approximately 2.5–6% of femoral fractures [2]. The average patient age is 35 years, and 75% of patients are male [3]. Most cases are
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