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.