Ipsilateral femoral neck and shaft fractures treated with Russell-Taylor reconstruction intramedullary nails.

BACKGROUND Ipsilateral femoral neck and shaft fractures are rare injuries and the treatment is complicated and versatile. No single device has been considered absolutely superior to others. METHODS Fifteen combined fractures in 15 patients were treated with Russell-Taylor reconstruction intramedullary nails (recon nails). Twelve surgeries were performed within 24 hours of trauma and the other 3 were delayed for 4-7 days due to associated life-threatening injuries. Postoperatively, protected weight bearing was permitted as early as possible. RESULTS The median operating time was 250 minutes (range 125-430 min) and median blood loss was 300 ml (range 100-600 ml). Thirteen patients were followed-up for a median of 22 months (range 13-45 months). The union rates for neck and shaft fractures were 84.6% and 69.2% respectively. The median union times were 3.0 months for neck fractures and 8.5 months for shaft fractures. CONCLUSIONS Recon nails are alternative acceptable devices to treat combined fractures. However, the stability of neck fixation may be insufficient and restriction of vigorous activity is suggested to avoid fixation failure.