Ipsilateral femoral neck and shaft fractures fixation with proximal femoral nail antirotation II (PFNA II): technical note and cases series
Abstract Background Combined ipsilateral femoral neck and shaft fractures are an uncommon type of fractures. A number of different implant options are available for the management of this injury. Two-device procedures were suggested because of the higher rate of malunion by single-device treatment....
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-01-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-019-1524-z |
| _version_ | 1811186609039605760 |
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| author | Kuen-Ting Wu Shih-Jie Lin Ying-Chao Chou Hsiang-Hen Cheng Po-Chong Wen Che-Han Lin Wen-Ling Yeh |
| author_facet | Kuen-Ting Wu Shih-Jie Lin Ying-Chao Chou Hsiang-Hen Cheng Po-Chong Wen Che-Han Lin Wen-Ling Yeh |
| author_sort | Kuen-Ting Wu |
| collection | DOAJ |
| description | Abstract Background Combined ipsilateral femoral neck and shaft fractures are an uncommon type of fractures. A number of different implant options are available for the management of this injury. Two-device procedures were suggested because of the higher rate of malunion by single-device treatment. However, surgical treatment using a cephalomedullary nail is still an alternative option that provides better mechanical advantage and minimal invasion. This study details the technique of treating these pattern fractures with proximal femoral nail anti-rotation II (PFNA-II) to achieve an acceptable reduction in both fracture sites. Methods Ten cases of ipsilateral femoral neck and shaft fractures under reduction by PFNA II were included and reviewed. A saw-bone model was also utilized to perform the detailed technique of reduction and fixation of PFNA II. Results Under the special technique by using the PFNA II, all ten cases achieved optimal reduction and alignment of both fracture sites in intra-operative fluoroscopy. There was no intra-operative complication noted. After 6 months of follow-up, radiography revealed proper alignment and well union of the fractures. Conclusions Fixation of ipsilateral femoral neck and shaft fractures with a single construct provides advantages of good biomechanical function, minimal invasion, reduced blood loss, and less operation time when comparing to two-device fixation. Thus, if acceptable reduction could be achieved, fixation by one PFNA II was a good alternative choice for this injury pattern. |
| first_indexed | 2024-04-11T13:49:12Z |
| format | Article |
| id | doaj.art-4425df13fd934fc9a9dc2108bc393af4 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:49:12Z |
| publishDate | 2020-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-4425df13fd934fc9a9dc2108bc393af42022-12-22T04:20:45ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-01-011511710.1186/s13018-019-1524-zIpsilateral femoral neck and shaft fractures fixation with proximal femoral nail antirotation II (PFNA II): technical note and cases seriesKuen-Ting Wu0Shih-Jie Lin1Ying-Chao Chou2Hsiang-Hen Cheng3Po-Chong Wen4Che-Han Lin5Wen-Ling Yeh6Department of Orthopaedic Surgery, Chang Gung Memorial HospitalDepartment of Orthopaedic Surgery, Chang Gung Memorial HospitalDepartment of Orthopaedic Surgery, Chang Gung Memorial HospitalDepartment of Orthopaedic Surgery, Chang Gung Memorial HospitalDepartment of Orthopaedic Surgery, Chang Gung Memorial HospitalDepartment of Orthopaedic Surgery, Chang Gung Memorial HospitalDepartment of Orthopaedic Surgery, Chang Gung Memorial HospitalAbstract Background Combined ipsilateral femoral neck and shaft fractures are an uncommon type of fractures. A number of different implant options are available for the management of this injury. Two-device procedures were suggested because of the higher rate of malunion by single-device treatment. However, surgical treatment using a cephalomedullary nail is still an alternative option that provides better mechanical advantage and minimal invasion. This study details the technique of treating these pattern fractures with proximal femoral nail anti-rotation II (PFNA-II) to achieve an acceptable reduction in both fracture sites. Methods Ten cases of ipsilateral femoral neck and shaft fractures under reduction by PFNA II were included and reviewed. A saw-bone model was also utilized to perform the detailed technique of reduction and fixation of PFNA II. Results Under the special technique by using the PFNA II, all ten cases achieved optimal reduction and alignment of both fracture sites in intra-operative fluoroscopy. There was no intra-operative complication noted. After 6 months of follow-up, radiography revealed proper alignment and well union of the fractures. Conclusions Fixation of ipsilateral femoral neck and shaft fractures with a single construct provides advantages of good biomechanical function, minimal invasion, reduced blood loss, and less operation time when comparing to two-device fixation. Thus, if acceptable reduction could be achieved, fixation by one PFNA II was a good alternative choice for this injury pattern.https://doi.org/10.1186/s13018-019-1524-zIpsilateral femoral neck and shaft fracturesProximal femoral nailReductionCephalomedullary nail |
| spellingShingle | Kuen-Ting Wu Shih-Jie Lin Ying-Chao Chou Hsiang-Hen Cheng Po-Chong Wen Che-Han Lin Wen-Ling Yeh Ipsilateral femoral neck and shaft fractures fixation with proximal femoral nail antirotation II (PFNA II): technical note and cases series Journal of Orthopaedic Surgery and Research Ipsilateral femoral neck and shaft fractures Proximal femoral nail Reduction Cephalomedullary nail |
| title | Ipsilateral femoral neck and shaft fractures fixation with proximal femoral nail antirotation II (PFNA II): technical note and cases series |
| title_full | Ipsilateral femoral neck and shaft fractures fixation with proximal femoral nail antirotation II (PFNA II): technical note and cases series |
| title_fullStr | Ipsilateral femoral neck and shaft fractures fixation with proximal femoral nail antirotation II (PFNA II): technical note and cases series |
| title_full_unstemmed | Ipsilateral femoral neck and shaft fractures fixation with proximal femoral nail antirotation II (PFNA II): technical note and cases series |
| title_short | Ipsilateral femoral neck and shaft fractures fixation with proximal femoral nail antirotation II (PFNA II): technical note and cases series |
| title_sort | ipsilateral femoral neck and shaft fractures fixation with proximal femoral nail antirotation ii pfna ii technical note and cases series |
| topic | Ipsilateral femoral neck and shaft fractures Proximal femoral nail Reduction Cephalomedullary nail |
| url | https://doi.org/10.1186/s13018-019-1524-z |
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