Treatment of long-segment fracture at middle-up part of femur with long proximal femoral nail antirotation.

Objective: To investigate the results of non-invasive operation method and evaluate clinical and radiological outcome of long proximal femoral nail antirotation in treating long-segment fracture at middle-up part of femur. Methods The retrospective study was conducted at the Second Hospital of Fuzhou, China, and comprised cases of long-segment fracture in middle-up part of femur power treated with long proximal femoral nail antirotation between June 2006 and December 2013. The patients were followed up for a minimum of 9 months. Clinical outcomes were evaluated according to Harris Hip Score and radiological examinations were done at 1, 2, 3, 6, 9 and 12 months and once a year thereafter. Results: Of the 139 patients, 104(75%) were males and 35(25%) females, within the age range of 18-86 years. The time period from injury to the index ranged from 3h to 15 days. The operative time of all cases ranged from 35 to 90 minutes, while the blood loss during surgery ranged from 30ml to 200ml. All patients walked with walking aid appliance 4-10 days post-operation with partial and gradually increasing to full weight-bearing. None of the patients developed infection, thrombus, cut-out or breakage of the implants. Follow-ups ranged from 9 to 37 months. According to Harris Hip Functional Score, 108(77.7%) cases behaved excellent, 22(15.9%) good, 8(5.7%) fair, and 1(0.7%) case poor. The good rate, as such, was 130(93.5%). Conclusion: Long proximal femoral nail antirotation is an effective treatment method for long-segment fracture at middle upper part of femur, with high healing rate, quick function recovery as well as less complication incidence.