FUNCTIONAL OUTCOME ASSESSMENT OF OSTEOSYNTHESIS IN IPSILATERAL FRACTURES OF HIP AND SHAFT OF FEMUR USING INTRAMEDULLARY RECONSTRUCTION NAIL

Abstract

Background- Fractures of ipsilateral hip and shaft of femur is an uncommon and complex pattern of injury. This combination of fractures usually occur in young individuals with history of high energy trauma like road traffic accidents and fall from height.

Methods- The study was conducted prospectively on patients admitted with concomitant fractures of ipsilateral hip and shaft of femur in the department of orthopaedics, SMS medical college and hospital, Jaipur during April 2016 to Nov2017. All data were analyzed by Epi-info software.

Results-Out of 13 patients who had delayed union, 9 patients had delayed union of shaft and 4 had delay in union of neck fracture. In 5 patients shaft of femur fracture failed to unite requiring further intervention. One patient developed fat embolism preoperatively, managed in intensive care unit. 9 patients had shortening, 3 had shortening <2cm and 6 patients had shortening between 2-3cm. One patient developed reverse Z-effect. 3 patients developed superficial infection. Malunion was seen in 14 patients, out of which 7 were trochanteric fracture 3 were neck of femur fracture and 4 were shaft fracture.

Conclusion- Reconstruction nail is a very good implant choice to fix both the fractures simultaneously with minimal soft tissue damage and providing biological fixation for both the fracture combination.

Keywords- Reconstruction Nail, Ipsilateral femoral neck-shaft fracture, Malunion