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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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Abstract

Introduction

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.

Materials and 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

All 28 patients achieved union of intertrochanteric fractures, while two 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.

Conclusions

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.

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Funding

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Busan, South Korea

    Won Chul Shin

  2. Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, South Korea

    Jae Hoon Jang & Seok Jin Jung

  3. Department of Orthopaedic Surgery, Bio-Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, 179 Gudeok-Ro Seo-Gu, Busan, 49241, South Korea

    Nam Hoon Moon

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  1. Won Chul Shin
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  2. Jae Hoon Jang
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Correspondence to Nam Hoon Moon.

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Shin, W.C., Jang, J.H., Jung, S.J. et al. 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. Eur J Trauma Emerg Surg 48, 1779–1786 (2022). https://doi.org/10.1007/s00068-020-01469-z

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  • DOI: https://doi.org/10.1007/s00068-020-01469-z

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