同側大腿骨頚部・骨幹部骨折の治療経験

抄録

We reviewed seven cases of ipsilateral fractures of the femoral neck and shaft treated at our hospital since 1989. There were four males and three females. Their ages ranged from 19 to 69 years (average, 44.9 years). All injuries resulted from high energy trauma.
There were two intracapsular femoral neck fractures and five extracapsular fractures (three were trochanteric and two were subtrochanteric fractures). There were no open fractures.
Two patients were treated with plate fixation for the shaft and compression hip screw fixation for the femoral neck, two were treated with an intramedullary nail for the shaft (Ender nail or Russell-Taylor nail) and pinning for the neck, and three were treated with Russell-Taylor reconstruction nail. One case had non-union and nail failure (Ender nail), so reoperation with plate fixation and an autobone graft was performed. The average follow-up was 19 months.
At follow-up, all patients had achieved a good result and all fractures were followed to union. There was no case of avascular necrosis of the femoral head.
Ipsilateral fractures of the femoral neck and shaft should be stabilized by internal fixation as early as possible. Russell-Taylor reconstruction nail is useful providing superior stabilization with a single implant.