Ayný taraf kalça ve femur cisim kýrýklarýnýn tedavisinde kullanýlan farklý tespit kombinasyonlarýnýn karþýlaþtýrýlmasý

A comparison of different fixation combinations for the treatment of ipsilateral hip and femoral diaphyseal fractures

BACKGROUND: The effects of four different fixation combinations were retrospectively evaluated on the treatment results of ipsilateral hip and femur fractures. METHODS: Ipsilateral hip and femur fractures of 19 patients (4 females, 15 males; mean age 26 years; range 18 to 41 years) were treated by four fixation combinations. In two groups, diaphysis fractures were treated by plate and screw fixation, and hip fractures by three cannulated screws (n=5) or dynamic hip screws (n=4). In another group, femur fractures were fixed with a retrograde intramedullary locking nail, and hip fractures by three cannulated screws (n=7). Finally, hip and diaphysis fractures in three patients were treated by an antegrade intramedullary locking nail through which a screw was sent to the collum. The mean time to surgery was four days (range 1 to 9 days) and the mean follow-up period was 22.5 months (range 12 to 33 months). RESULTS: All femoral diaphyseal fractures healed in a mean of 3.5 months (range 2.5 to 8 months). No significant differences were found with respect to localization of fractures and amount of displacement, time to healing for hip fractures, the length of hospital stay, and complications. Compared to the other groups, fixation with a retrograde intramedullary locking nail resulted in significantly less healing period (p=0.034), operation time (p<0.001), and blood transfusion during surgery (p=0.025). No patients exhibited decreased range of motion of the hip or implant failure. CONCLUSION: The use of a retrograde intramedullary locking nail with percutaneous screw fixation seems to be more advantageous in the treatment of ipsilateral hip and diaphyseal femoral fractures.