Advantages and limitations of intramedullary nailing for the surgical treatment of ipsilateral intertrochanteric and fem
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ORIGINAL ARTICLE
Advantages and limitations of intramedullary nailing for the surgical treatment of ipsilateral intertrochanteric and femoral shaft fractures: a retrospective comparative study based on propensity score matching Won Chul Shin1 · Jae Hoon Jang2 · Seok Jin Jung2 · Nam Hoon Moon3 Received: 16 July 2020 / Accepted: 21 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction The aim of the present study was to introduce surgical technique using long PFNA for the treatment of ipsilateral intertrochanteric and femoral shaft fractures, and evaluate the characteristics of this fracture by comparing its surgical outcomes with those of isolated intertrochanteric and femoral shaft fractures. Materials and methods Between March 2013 and December 2018, 38 patients with ipsilateral intertrochanteric and femoral shaft fracture were identified at two institutions. Twenty-eight patients with ipsilateral intertrochanteric and femoral shaft fractures were enrolled in the present study. After propensity score matching, fifty-six patients with isolated intertrochanteric (group B) and femoral shaft (group C) fractures were finally enrolled in the present study for 1:2 matching to compare surgical outcomes to that of ipsilateral intertrochanteric and femoral shaft fractures (Group A). Results All 28 patients achieved union of intertrochanteric fractures, while two experienced non-union of femoral shaft fractures. The union time of intertrochanteric fractures in group A was significantly shorter than that in group B. The union time of femoral shaft fractures in group A was significantly longer than that in group C. Conclusions The surgical treatment of ipsilateral intertrochanteric and femoral shaft fractures using long PFNA was advantageous as it allowed both fractures on the same femur to be fixed in one go and showed good surgical outcomes. However, fixation of femoral shaft fractures might be insufficient depending on the fracture level and configuration, and can be a cause of hypertrophic non-union. Keywords Intramedullary nailing · Ipsilateral intertrochanteric and femoral shaft fracture · Intertrochanteric fracture · Femoral shaft fracture
Introduction
* Nam Hoon Moon [email protected] 1
Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, South Korea
2
Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, South Korea
3
Department of Orthopaedic Surgery, Bio‑Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, 179 Gudeok‑Ro Seo‑Gu, Busan 49241, South Korea
Ipsilateral intertrochanteric and femoral shaft fractures are rare forms of femoral fractures and related to high-energy injuries such as motor vehicle accidents and falls from heights [1–5]. To date, there is limited literature about this fracture. Thus, little is known about the nature and outcomes of this form of fracture, as well as its re
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