Percutaneous joystick reduction with reductor-T tape pin and fixation with a reconstruction nail for the treatment of ipsilateral femoral neck and shaft fractures

Abstract

Objectives: This study aims to investigate the efficacy and safety of a reconstruction nail combined with a percutaneous reductor-T tape pin for treating ipsilateral femoral neck and shaft fractures.

Patients and methods: Between January 2013 and December 2021, a total of 25 adult patients (19 males, 6 females, mean age: 32.8±10.9 years; range, 19 to 57 years) who sustained concurrent ipsilateral femoral neck and shaft fractures were included. The patients underwent internal fixation using a reconstruction nail with the assistance of a reductor-T tape pin, employing percutaneous techniques. The operation time, reduction time, fluoroscopy time, blood loss, preoperative and postoperative Visual Analog Scale (VAS) scores, fracture union time, Harris scores of the healthy and affected sides after fracture union, complications and lower limb functional outcomes two years post-surgery were recorded.

Results: All patients underwent successful surgery with the assistance of the reductor-T tape pin using percutaneous techniques without the need for open reduction. The mean operation time from skin incision to wound closure was 80.0±15.0 (range, 55 to 105) min. The mean fracture reduction time was 22.0±4.0 (range, 15 to 28) min. The mean fluoroscopy time was 16.0±3.8 (range, 9 to 25) sec. The mean blood loss was 335.0±142.0 (range, 150 to 550) mL. The postoperative VAS score of the affected limb was significantly lower than the preoperative score (p<0.01). The mean healing time of femoral neck fractures was 4.0±0.3 (range: 3.2 to 4.8) months. The mean healing time of femoral shaft fractures was 4.8±0.9 (range, 4.1 to 7.5) months. All patients were followed for over two years. No cases of delayed healing of femoral neck fractures or femoral head necrosis were observed. However, delayed union of femoral shaft fractures occurred in three patients. There was no statistically significant difference in Harris scores between the affected and healthy sides at the time of fracture healing (p>0.05).

Conclusion: The use of a reconstruction nail assisted by the percutaneous reductor-T tape pin demonstrated successful reduction of ipsilateral femoral neck and shaft fractures, with favorable postoperative functional outcomes. The reductor-T tape pin facilitates the reduction of femoral neck fractures and provides a safe environment for the reduction and fixation of femoral shaft fractures.

* These authors contributed equally to this study

Citation: Wang W, Guo Z, Yang L, Qiao Y, Guo J, Liu J, et al. Percutaneous joystick reduction with reductor-T tape pin and fixation with a reconstruction nail for the treatment of ipsilateral femoral neck and shaft fractures. Jt Dis Relat Surg 2025;36(3):489- 500. doi: 10.52312/jdrs.2025.2200.

Contributed to conception, design, supervosoin, writing-original draft and writingreview: W.W.; Contributed to conception, design, writingoriginal draft and writing-editing: Z.G.; Contributed to date analysis and writing-original draft: L.Y.; Contributed to data collection: Y.Q., J.G., J.L., S.L., Z.L. All authors read and approved the final manuscript.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.

The data that support the findings of this study are available from the corresponding author upon reasonable request.