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Published on: June 6, 2025
Functional and Radiological Outcomes of Ipsilateral Femoral Neck and Shaft Fractures Treated with Proximal Femoral
Ravindra Mohan1, Shailendra Singh, Sujeet Kumar Chaudhary
1Department of Orthopedics, King George's Medical University, Lucknow, Uttar Pradesh, India.
Background:
Ipsilateral femoral neck and shaft fractures present a unique challenge due to their complex biomechanics and the need for optimal implant selection. Traditional dual-implant fixation has been widely used, but a single implant approach, such as the Proximal Femoral Nail Antirotation-2 (PFNA2), offers potential advantages, including reduced surgical time, minimized blood loss, and lower implant-related complications. However, the stability provided by PFNA2 and its impact on early functional recovery remain areas of ongoing investigation.
Materials And Methods:
This prospective study analyzed 20 patients (14 males and 6 females) aged 22-44 years (mean: 34.5 years) with ipsilateral femoral neck and shaft fractures managed using PFNA2. Functional outcomes were evaluated using the Harris-Hip Score (HHS) and Friedman-Wyman Scoring System at 3, 6, and 12 months postoperatively. Radiological assessments included time to fracture union for both the neck of femur (NOF) and the shaft of femur (SOF). Additional parameters such as surgical duration and functional weight-bearing status were recorded. Complications, including infections, delayed union, and implant-related failures, were monitored.
Results:
The mean HHS improved from 54.3 at 3 months to 81.9 at 12 months. Functional weight-bearing scores increased from a mean of 2 at 3 months to 4 at 12 months. Mean fracture union time was 3.5 months for NOF and 5.35 months for SOF. Most patients achieved functional weight-bearing within 4 months. The mean surgical duration was 87.2 min. Complications included superficial infections (10%), delayed union (15%), and mild varus collapse (5%), with no cases of nonunion or implant failure.
Conclusion:
PFNA2 provides biomechanical stability, promotes early mobilization, and minimizes the need for multiple implants in ipsilateral femoral neck and shaft fractures. Proper surgical technique and postoperative care are essential to optimize outcomes and reduce complications.
