Iatrogenic fracture neck femur while internal fixation of fracture shaft femur by femur interlocking nail

Abstract

Purpose: We have reviewed our experience of three iatrogenic femoral neck fractures in 190 femoral fracture of shaft femur which were operated by close reduction and internal fixation by femoral interlock nail. Materials & Methods: We reviewed our experience of close femoral nailing and made radiographic measurement of neck shaft angle in blind manner as to occurrence of fracture neck femur.Results & Discussion: The average neck shaft angle in the bone that fractured was 140+1 SD (139-141). We believe that excessive adduction of limb for reduction of fracture may cause fracture of neck femur. Also, excessive maneuver using nail or reamer for reduction also causes fracture of neck femur. Out of the three iatrogenic fractures, one was unicortical, undisplaced with intact calcar. It was fixed using two 4.5 mm malleolar screw. Remaining two were bicortical but undisplaced which were again fixed by two 4.5 mm malleolar screw. Conclusion: We have found that fixation of iatrogenic fracture neck femur while doing femoral interlock nail by malleolar screw rather than removing the nail and doing Proximal Femur Nailing is good option in the view operative time, blood loss and infection.