Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (3): 403-408.doi: 10.3969/j.issn.2095-4344.2950

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Comparison of three different internal fixation methods in treatment of ipsilateral femoral neck and shaft fracture

Xiang Feifan, Ye Junwu, Zhang Xihai, Ge Jianhua, Tang Lian, Yang Yunkang   

  1. Department of Bone and Joint Surgery, Affiliated Hospital of Southwest Medical University, Luzhou  646000, Sichuan Province, China
  • Received:2020-02-25 Revised:2020-03-04 Accepted:2020-04-03 Online:2021-01-28 Published:2020-11-17
  • Contact: Yang Yunkang, MD, Professor, Department of Bone and Joint Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
  • About author:Xiang Feifan, Master, Physician, Department of Bone and Joint Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
  • Supported by:
     the Project of Southwest Medical University, 2017-ZRQN-129; the Project of Affiliated Hospital of Southwest Medical University, No. 2017-PT-47

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Abstract: BACKGROUND: Ipsilateral femoral shaft and neck fracture is a rare clinical injury, and its treatment has attracted more and more attention from scholars. At present, there are many internal fixation methods.
OBJECTIVE: To retrospectively analyze efficacy of three internal fixation methods in the treatment of ipsilateral femoral shaft and neck fracture, and its indications.
METHODS: Thirty-three cases of ipsilateral femoral neck and shaft fracture treated by three different internal fixation implants between January 2015 and September 2018 were retrospectively studied. Patients were divided into three groups according to different internal fixation: intramedullary nail only group (group A; n=11), retrograde nail with cannulated screw group (group B; n=10) and plate with cannulated screw group (group C; n=12). The general clinical data, the intraoperative situations, the postoperative follow-up conditions and complications were compared among the three groups.
RESULTS AND CONCLUSION: (1) There was no significant difference between the three groups with regard to age, gender, cause of injury, AO fracture classification, Garden classification and average time from injury to surgery (P > 0.05). (2) There were statistically significant differences among the three groups in incision length (P < 0.05); no significant difference in incision length was found between the groups A and B (P > 0.05); the incision length was smaller in groups A and B than in group C (P < 0.05). There were no significant differences among the three groups in operation time and intraoperative blood loss (P > 0.05). (3) There were no significant differences among the three groups in time to bony union in both femoral shaft and neck, complication rate, and excellent and good rate of Harris hip score (P >  0.05). (4) Femoral neck fracture delayed healing occurred in one case of the group A; re-fracture occurred in one case of the group B; and the fracture end was located under the femoral tuberosity; screw loosening occurred in one case of the group C. (5) It is indicated that all three internal fixation methods can achieve good therapeutic effects. The operator can choose the skilled internal fixation method according to the specific conditions of the patient.

Key words: bone, femur, fracture, femoral shaft, femoral neck, internal fixation, intramedullary nail, complications

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