• Wen-yue Wang, Tian-fu Yang, Lei Liu, Fu-xing Pei, and Li-ming Xie.
• Department of Orthopaedic Surgery, Guang'anmen Hospital, China Academy of Chinese Medicine Science, Beijing, China.
• Orthop Surg. 2012 Feb 1; 4 (1): 41-6.

ObjectiveTo compare the results of long proximal femoral nail antirotation (PFNA-long) and plate combinations in the treatment of ipsilateral intertrochanteric and femoral shaft fractures.MethodsBetween March 2004 and April 2009, 23 patients with ipsilateral intertrochanteric and femoral shaft fractures were treated with PFNA-long or plate combinations. The patients were divided into two groups. Group I contained 13 patients who were treated with dynamic hip screws (DHS) combined with compression plate fixation. The 10 patients in Group II were treated with PFNA-long.ResultsThe average follow-up was 17.8 and 16.8 months for Groups I and II, respectively. The average union time for intertrochanteric fractures was 17.4 and 16.6 weeks in Groups I and II, respectively, and for femoral shaft fracture 22.2 and 21.5 weeks, respectively. There were nine good, two fair, and two poor functional results in Group I, and eight good, one fair, and one poor in Group II. There was nonunion of two femoral shaft fractures in Group I and one in Group II. There were no significant differences between the two groups in functional outcomes or major complications.ConclusionBoth treatment methods achieve satisfactory functional outcomes in patients with ipsilateral intertrochanteric and femoral shaft fractures. PFNA-long is the better choice for the treatment of complex fractures, having the advantages of minimal exposure, reduced perioperative blood loss, and achievement of biological fixation of both fractures with a single implant.© 2012 Tianjin Hospital and Blackwell Publishing Asia Pty Ltd.

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