RUSSEL-TAYLOR RECONSTRUCTION NAIL IN THE TREATMENT OF IPSILATERAL NECK AND SHAFT FRACTURES

Eleven ipsilateral neck and shaft fractures of the femur in 11 patient s (4 females, 7 males) were treated between May 1987 and December 1990 at the Department of Orthopedic Surgery, University of Louisville, Tr auma center level one. The mean age was 34.5 (16-60) years. All patien ts sustained their injuries from high energy trauma (8 traffic acciden ts, 3 falls). All neck fractures were closed and there were 8 closed a nd 3 open (grade I, grade II, grade IIIA = one each) shaft fractures. All fractures were operated on the fracture table and all were stabili zed with the Russell-Taylor reconstruction nail. Thus, antegrade reame d nailing of the shaft fracture was followed by internal fixation of t he neck fracture with 8.0 mm and 6.4 mm lag screws. Those were placed with a targeting device through the proximal locking holes of the nail . Then, the distal locking bolts were implanted by free hand technique . The mean follow-up was 36.2 (18-71) months. All fractures of the nec k and shaft healed. There was no necrosis of the femoral head. No infe ction was observed. The mean healing time for the neck fractures was 1 3.4 weeks and 16.8 weeks for the shaft fractures. In one case autogeno us cancellous bone grafting was performed in delayed healing of a shaf t fracture. There were no varus or valgus malangulations. Five patient s had a minor limited ROM of the hip joint, another 6 patients an aver age shortening of 1.3 cm of he involved leg. In one case a locking bol t had to be removed due to loosening. The Russell-Taylor reconstructio n nail is a favourable device for the stabilization of ipsilateral fra ctures of the femoral neck and shaft and provides excellent results fo r these complex injuries.