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
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Authors
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Nam Hoon Moon
- Pusan National University, Busan, Korea, Republic of (South Korea)
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Won Chul Shin
- Pusan national university Yangsan Hospital, Medical School of Pusan National University, Busan, Korea, Republic of (South Korea)
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Jung Sub Lee
- Pusan National University, Busan, Korea, Republic of (South Korea)
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Tae Sik Goh
- Pusan National University, Busan, Korea, Republic of (South Korea)
| Published: | October 25, 2022 |
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Outline
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Objectives: 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.
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 and conclusion: All 28 patients achieved union of intertrochanteric fractures, while 2 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.
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.
