The rendezvous technique for the treatment of ipsilateral femoral neck and shaft fractures: A case series

Harewood, Seun; Mencia, Marlon; Harnarayan, Patrick

doi:10.1016/j.tcr.2020.100346

Cited by 6 publications

(5 citation statements)

References 13 publications

(21 reference statements)

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“…Harewood, S et al reported case series of 3 patients treated by rendezvous technique. 18 Limitations of the current study are relatively small number of sample size, retrospective nature of study, absence of analysis of the fracture union and single centre study. Multicentre study involving large number of cases with analysis of outcome may provide further evidence to substantiate the findings of this study.…”

Section: Discussionmentioning

confidence: 89%

Magnitude of Fracture Neck of Femur in Patients With Ipsilateral Fracture Shaft of Femur in Adult

Das,

Pandey,

Gupta

et al. 2023

JCMC

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Background: Magnitude of fracture neck of femur associated with ipsilateral fracture shaft of femur is rare and challenging in terms of diagnosis and management. Fracture neck of femur is associated with 0.8-9 % of ipsilateral fracture shaft of femur. Fracture neck of femur is often missed preoperatively with incidence ranging from 20-50%. This study was done with an objective of assessing the magnitude of fracture neck of femur in patients with ipsilateral fracture shaft of femur. Methods: This was descriptive study of retrospective data of 187 fracture shaft of femur. Data from all the patients with fracture shaft of femur in the age group of 17 to 70 years admitted and operated between September 2018 to September 2022 were analyzed with magnitude of ipsilateral fracture neck of femur diagnosed preoperatively or postoperatively as main variable. Descriptive statistics was used to calculate frequency and percentage. Results: Out of 187 fracture shaft of femur, 8.02% (n=15) cases were associated with ipsilateral fracture neck of femur. 73.33% (n=11) cases of fracture neck of femur were identified preoperatively on plain radiograph whereas diagnosis of 26.66% (n=4) cases of fracture neck of femur was missed on initial evaluation and diagnosed on postoperative plain radiograph. Conclusions: Current study showed the magnitude of fracture neck of femur as 8.02% associated with ipsilateral fracture shaft of femur. Careful clinical evaluation, proper radiography of hip, possible CT scan in doubtful cases and intraoperative fluoroscopic evaluation of hip may decrease the incidence of missed diagnosis.

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Section: Discussionmentioning

confidence: 89%

Magnitude of Fracture Neck of Femur in Patients With Ipsilateral Fracture Shaft of Femur in Adult

Das,

Pandey,

Gupta

et al. 2023

JCMC

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“…Technically speaking, case series that used "miss the nail" screws along with conventional nails should also be considered double implants [4,9]. A newly introduced rendezvous technique, described by Harewood et al [29], used an overlapping area of the nail and DHS plate, with one of the screws passing through both the plate hole and the nail. This technique prevents a stress riser in the area not otherwise spanned by either of the implants [27,29].…”

Section: Discussionmentioning

confidence: 99%

“…Most authors feel that femoral neck fixation takes precedence to avoid further injury to the femoral head blood supply [3,4]. However, others opine for fixation of the femoral shaft first to have better control during indirect reduction of the neck [20,29]. The hip fracture component of these injuries is mildly displaced or undisplaced [11,17].…”

Section: Discussionmentioning

confidence: 99%

Clinicoradiological Outcome of Concomitant Fractures of Proximal Femur and Femoral Shaft Treated With Second-Generation Cephalomedullary Nailing

Baghel¹,

Keshav²,

Kumar³

et al. 2021

Cureus

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BackgroundThe ideal modality of treatment of concomitant fractures of the hip (intertrochanteric/femoral neck) and the femoral shaft is still evolving. The aim of our retrospective study was to assess the clinicoradiological outcome of such fractures managed by closed second-generation cephalomedullary nailing. MethodologyThe study was conducted among skeletally mature patients presenting within one week of injury who underwent closed second-generation cephalomedullary nailing (proximal femoral nail). Those presenting beyond one week or those who had pathological fractures, incomplete follow-ups, or other modes of fixation were excluded. Functional results were evaluated according to Friedman and Wyman's clinical assessment system. Time required for fracture healing and the presence of any complications were also noted. ResultsA total of 10 patients with the ipsilateral hip (five intertrochanteric and five femoral neck) and femoral shaft fractures were included in the study. Associated injuries found included fractures of the ipsilateral tibia/fibula at varying levels in three patients; hand and wrist injuries in two patients; and contralateral femoral shaft fracture, ipsilateral patella, bilateral crush injury of the foot, and head and chest injury with brachial plexus injury in one patient each. Four patients were diagnosed with intra-articular knee injuries (ligamentous and meniscal injuries) postoperatively. At the final follow-up, the functional outcome results were good in four, fair in one, and poor in five patients. All femoral neck fractures united at a mean of 15.2 weeks (range: 12.0-18.0 weeks) and intertrochanteric fractures at a mean of 14.0 weeks (range: 12.0-22.0 weeks). However, there was residual varus malunion in two intertrochanteric fractures. Eight femoral shaft fractures were infra-isthmic; of these, four resulted in nonunion (two of hypertrophic and two of atrophic type) and two were found to be in the delayed union, which eventually united by 24 weeks. ConclusionsSecond-generation cephalomedullary nail is an acceptable, cost-effective, and minimally invasive alternative for the management of concomitant ipsilateral fractures of the hip and supra-isthmic or isthmic femoral shaft fractures. For infra-isthmic fractures, retrograde femoral nail or distal femoral plate along with a separate implant for addressing the hip fracture (either cannulated cancellous screw or dynamic hip screw, preferably in a rendezvous/overlapping manner) are better options.

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“…In our recent report, we described the dual-implant rendezvous technique as an effective treatment for ipsilateral femoral neck and shaft fractures [ 13 ]. While this technique often produces good results, there are occasional instances where the femoral neck fixation fails, requiring revision surgery [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Conversion hip arthroplasty for failed internal fixation of ipsilateral femoral neck and shaft fractures: a case report

Mencia

Cruz²

2023

Patient Saf Surg

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Background Ipsilateral femoral neck and hip fractures are uncommon high energy injuries. In the literature no single method of treatment has emerged as superior to the others. A recent publication has documented the successful application of the rendezvous technique using dual-implants for treating these injuries. However in some cases, this technique may fail and revision surgery is required. Case presentation A 67-year old man sustained ipsilateral fractures of his femur and femoral neck in a road traffic accident. His injuries were treated by a dual construct consisting of a retrograde femoral nail and dynamic hip screw. Three months after surgery the hip screw cut out of the femoral head necessitating revision to a total hip arthroplasty. Surgery was carried out using a single stage two part procedure on a standard operating table without having to reposition or redrape the patient. There were no postoperative complications and at 1 year from surgery the patient is satisfied with the result and has returned to work. Conclusion Conversion hip arthroplasty in the presence of dual implants is a technically challenging and unpredictable procedure, with an increased risk of complications. Our surgical approach provides a framework for orthopedic surgeons to safely perform this complex procedure.

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The rendezvous technique for the treatment of ipsilateral femoral neck and shaft fractures: A case series

Cited by 6 publications

References 13 publications

Magnitude of Fracture Neck of Femur in Patients With Ipsilateral Fracture Shaft of Femur in Adult

Magnitude of Fracture Neck of Femur in Patients With Ipsilateral Fracture Shaft of Femur in Adult

Clinicoradiological Outcome of Concomitant Fractures of Proximal Femur and Femoral Shaft Treated With Second-Generation Cephalomedullary Nailing

Conversion hip arthroplasty for failed internal fixation of ipsilateral femoral neck and shaft fractures: a case report

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