Antegrade Femoral Nailing in Acetabular Fractures Requiring a Kocher-Langenbeck

Full article available online at Healio.com/Orthopedics. Search: 20130821-18 abstract Ipsilateral displaced acetabular and femoral shaft fractures represent a dilemma for orthopedic surgeons because antegrade femoral nailing may complicate a Kocher- Langenbeck acetabular exposure. The goals of this study were to review the results of ipsilateral femoral and acetabular fracturestreated with antegrade femoral nailing and a Kocher-Langenbeck approach and to evaluate the assertion that this treatment strategy is associated with increased morbidity. This was a retrospective cohort study at a regional Level I trauma center. Sixteen patients with a femoral fracturetreated with antegrade nailing and an ipsilat- eral acetabular fracturetreated with a Kocher-Langenbeck approach were identified. One patient died as a result of his injuries, and 2 were not available for long-term fol- low-up. One had a deep infection requiring irrigation, debridement, and intraveonous antibiotics. One patient developed a hematoma requiring irrigation and debridement. At final follow-up, 2 patients had no heterotopic ossificationabout the hip, 4 had Brooker class I heterotopic ossification, 3 had Brooker class II heterotopic ossification, 2 had Brooker class III heterotopic ossification, and 2 patients had Brooker class IV heterotopic ossificationrequiring excision. Ipsilateral femoral and acetabular fracturesrepresent a rare and severe injury constellation. Antegrade nailing of the femur with ipsilateral Kocher-Langenbeck exposure for fixation of the acetabulumwas not as - sociated with excessive rates of wound-healing complications, but the incidence of heterotopic ossificationwas increased.