Study on proximal femoral nail antirotation in surgical treatment of femoral proximal with shaft fracture

Objective To find an appropriate way in surgery treatment of ipsilateral femoral proximal fracture combine with shaft fracture.Methods We retrospectively analyzed 52 cases which came across holistic fixation [Long proximal femoral nail anti-rotation (PFNA)\Long dynamic hip screw (DHS)] or separate fixation surgery in our department from 1999 to 2009.Results All cases were followed-up for 4 to 25 months,average of 9.3 months.All of them got heal.Separate fixation group was good in reduction but worse in function and a longer healing time.Holistic fixation group was reliable in reduction and best in function.Conclusion In this circumstance holistic fixation is better than separate fixation.Intramedullary nail is better than plate.Long PFNA showed a better result in this study than any other methods,probably because of its unique structure and operation procedure.And some critical points should be focused during Long PFNA and reconstruction nail. Key words: Proximal femur, Segmental fracture;  PFNA;  Reconstruction nail;  DHS;  Cannulated screw