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Background Managing intertrochanteric fractures presents challenges for orthopedic surgeons, not only in fixing the fracture but also in preventing and managing associated complications, especially in the vulnerable geriatric population. Cephalomedullary nails are commonly used for surgical fixation due to their favorable functional profile, which preserves the hip's abductor lever arm and proximal femur anatomy. However, there's a lack of data comparing two major options: proximal femoral nail (PFN) and proximal femoral nail anti-rotation (PFNA). This study aimed to compare the radiological fracture reduction and fixation as well as functional outcomes of these two implants in treating intertrochanteric fractures. Methods The study, spanning 24 months, involved a prospective comparative design. Participants included patients diagnosed with intertrochanteric femur fractures classified as AO Type 31 A1, AO Type 31 A2, and AO Type 31 A3. Fifty patients were evenly distributed into PFN and PFNA groups. Preoperatively, clinical and radiological assessments were conducted, along with serum vitamin D level measurements. Surgeries, performed under anesthesia with image intensifier guidance, followed defined reduction and implant insertion protocols for each group. Postoperatively, evaluations were conducted up to six months, examining parameters such as tip-apex distance (TAD), Cleveland index, and modified Harris hip score, while documenting intraoperative duration and blood loss. Data analysis utilized the statistical software Statistical Package for Social Sciences (SPSS), version 22.0 (IBM Corp., Armonk, NY), employing descriptive statistics, chi-square tests, independent t-tests, and paired t-tests, with significance set at p < 0.05. Results In our study, 50 patients were enrolled, with equal gender distribution (64.0% male, 36.0% female, p=1.000). The mean ages in the PFN and PFNA groups were 66.2 ± 9.8 years and 66.4 ± 11.3 years, respectively (p=0.936). All fractures united by six months, with no implant-related complications reported. PFNA showed significantly lower blood loss and shorter surgery durations (p<0.001). TAD and neck shaft angle were similar between groups (p=0.826, p=0.555). Cleveland index placement and modified Harris hip score improvement were comparable (p=0.836, p<0.001). Predominant vitamin D deficiency was observed in both groups. Conclusion PFNA offers measurable intraoperative benefits over conventional PFN in terms of operative time, blood loss, and need for fluoroscopic imaging. However, no statistically observable benefits were noted in postoperative functional outcomes or complications between the two implants.
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BACKGROUND: Recurrent anterior shoulder dislocation (RASD) in cases of seizure disorders (SDs) total 50%-80% of all SD-associated shoulder instabilities. Based on the extent of bone loss, treatment options include bony and soft-tissue reconstructions, arthroplasty, and arthrodesis. The primary objective of this paper was to review the treatment options for RASD in SDs. METHODS: Several bibliographic databases were searched for RASD treatment options in SD patients. The demographic outcome measures, the failure rate (defined as the relative risk of recurrence of dislocation postoperation), and the postoperative seizure recurrence rate were recorded. RESULTS: We pooled 171 cases (187 shoulders) from 11 studies. Of these, one, five, two, two, and one reports studied Bankart's operation with remplissage (27 cases/29 shoulders), the Latarjet procedure (106/118), bone block operation (21/23), arthroplasty (11/11), and arthrodesis (6/6), respectively, in treating SD-associated RASD. The relative risk of failure between SD and non-SD patients was 3.76 (1.3610.38) after the Latarjet operation. The failure rates were 17% and 13% for Bankart's operation with remplissage and the Latarjet procedure in SD patients, respectively, but 0% each for bone block operation, arthroplasty, and arthrodesis. The total rate of seizure recurrence after operation was 33% of the pooled cases. CONCLUSIONS: SD recurrence in the postoperative period, the size of the bone block, and the muscular attachments to a small coracoid autograft are the determinants of failure among various reconstructive operations in SD-associated RASD. Level of evidence: III.
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The present article portrayed on the killing kinetic of human pathogenic bacteria using bioinspired mesoporous CuAl2O4 nanocomposites (NCs). The NCs was fabricated using leaf extract of medicinal plant Catharanthus roseus (CR) as a green reducer and stabilizer. As bio-fabricated material was calcined at 800 °C and characterized by several analytical techniques like X-ray Diffraction (XRD), Fourier Transform Infrared Spectroscopy (FT-IR), Ultraviolet-Visible Diffuse Reflectance Spectroscopy (UV-DRS), Energy Dispersive X-Ray Spectroscopy (EDS), X-Ray Photoelectron Spectroscopy (XPS), Raman, Brunauer-Emmett-Teller (BET), Scanning Electron Microscopy (SEM), and Transmission Electron Microscopy (TEM) to authenticate its structure, phase, chemical bonding, chemical state, size and morphology behaviors. XRD and TEM revealed a reduced crystallite and nanoscale sizes of biosynthesized NCs. Moreover, XRD study exposed a cubic-structure of material, while transmission electron microscopy rendered an average particles size in range 10-15 nm. However, BET profile advocates a mesoporous nature of the particles. An effective biological molecular docking modulation assessed by substituting natural inhibitor by bioinspired NCs, while the protein PDB ID 4Z8D FabH as a receptor site for the present investigation. After assessment of molecular docking examination, the antibacterial activity of bioinspired NCs were performed against Staphylococcus aureus, Bacillus subtillis, Klebsiella pneumoniae and Escherichia coli using agar-well method. The broth culture method was employed on different pathogenic strains by kinetic growth assays and colony forming unit.
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Catharanthus , Nanocompostos , Extratos Vegetais , Catharanthus/química , Nanocompostos/química , Cinética , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Antibacterianos/farmacologia , Antibacterianos/química , Simulação de Acoplamento Molecular , Escherichia coli/efeitos dos fármacos , Difração de Raios X , Folhas de Planta/química , Espectroscopia de Infravermelho com Transformada de Fourier , Testes de Sensibilidade Microbiana , Staphylococcus aureus/efeitos dos fármacosRESUMO
The current work describes a facile synthesis of spinel-type ZnCo2O4 along with an additional phase, Co3O4, by simply maintaining a non-stoichiometric ratio of Zn and Co precursors. Pure ZnCo2O4 and Co3O4 were also synthesized using the same method to compare results. The obtained morphologies of samples show that small-sized nanoparticles are interconnected and form a porous nanosheet-like structure. When used as anode materials for Li-ion batteries, the ZnCo2O4/Co3O4 nanocomposite electrode exhibits a highly stable charge capacity of 1146.2 mA h g-1 at 0.5C after 350 cycles, which is superior to those of other two pure electrodes, which can be attributed to its optimum porosity, synergistic effect of ZnCo2O4 and Co3O4, increased active sites for Li+ ion diffusion, and higher electrical conductivity. Although the pure Co3O4 electrode displayed a much higher rate capability than the ZnCo2O4/Co3O4 nanocomposite electrode at all investigated current rates, the Co3O4 morphology apparently could not withstand long-term cycling, and the electrode became pulverized due to the repeated volume expansion/contraction, resulting in a rapid decrease in the capacity.
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Herein, a mesoporous MnCo2O4/Co3O4 nanocomposite was fabricated using a polyvinylpyrrolidone (PVP)-assisted hydrothermal synthesis method by maintaining only the non-stoichiometric ratio of Mn and Co (2 : 6), leading to an extra phase of Co3O4 coupled with MnCo2O4. Microstructural analysis showed that the obtained sample has a uniform nanowire-like morphology composed of interconnected nanoparticles. The stoichiometric ratio (2 : 4) was maintained to synthesize pure MnCo2O4 for comparative analysis. However, the obtained structure of pure MnCo2O4 was found to be irregular and fragile. After their employment as anode-active materials, the nanocomposite electrode showed superior high rate capability (1043.8 mA h g-1 at 5C) and long-term cycling stability (773.6 mA h g-1 after 500 cycles at 0.5C) in comparison to the pure MnCo2O4 electrode (771.5 mA h g-1 at 5C and 638.9 mA h g-1 at 0.5C after 500 cycles). It was believed that the extra phase of Co3O4 may also participate in the electrochemical reactions due to its high electrochemically active nature. Benefiting from the appealing architectural features and striking synergistic effect, the integrated MnCo2O4/Co3O4 nanocomposite anode exhibits excellent electrochemical properties and high cycle stability for LIBs.
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SummarySciatic nerve injury after total hip replacement is rare with a reported incidence of about 0.09%-3.7%. The most commonly reported causes include traction on the nerve during reduction, compression of the nerve from subfascial haematoma, significant leg lengthening, improper retractor placement, thermal burns from cautery and extraneous cement. We present a case of complete sciatic nerve palsy in a patient operated on using direct anterior approach (DAA). To date, there are no reports describing sciatic nerve palsy secondary to haematoma immediately after primary arthroplasty through the DAA. We performed an MRI of lumbosacral spine with both hips, which revealed a haematoma. Consequently, we promptly took the patient to the operation theatre for re-exploration. Using the same approach, we dislocated the hip and removed the clots. By the end of 2 weeks, the patient was able to dorsiflex the ankle and had fully recovered from sciatic nerve palsy.
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Artroplastia de Quadril , Neuropatia Ciática , Humanos , Artroplastia de Quadril/efeitos adversos , Hematoma/complicações , Quadril , Nervo Isquiático , Neuropatia Ciática/etiologia , Pessoa de Meia-IdadeRESUMO
Introduction: Pipkin type 4 fracture is defined as hip dislocation with femoral head fracture and concomitant acetabular rim fracture. These fractures are rare. Neglected fractures develop adaptive changes in the acetabulum, femoral head, and soft tissues around the hip joint, leading to hip arthritis. Total hip arthroplasty is preferred in such cases. After an extensive literature review, we did not find any guidelines for managing neglected Pipkin type 4 fractures. Case Report: A 47-year-old male presented with pain in his left hip and an inability to bear weight on his left lower limb. He had a road traffic accident 1 year ago. On clinical examination, there was a shortening of 3 cm and reduced hip range of motion on 3D computed tomography posterosuperior defect of the acetabular wall along with Pipkin type 4 femoral head fracture was detected. Total hip arthroplasty with acetabular reconstruction using a femoral head autograft was done. At 1 year of follow-up, the patient was pain-free and could walk without any assistance with a normal gait. Conclusion: Uncemented total hip arthroplasty with an autologous structural femoral head graft is a suitable method of treatment for neglected Pipkin type 4 fractures. It preserves bone stock and does not add any financial burden.
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Recently, aqueous zinc ion batteries (AZIBs) have attracted significant attention owing to their high safety, low cost, and abundant raw materials. However, finding an affordable and stable cathode, which can reversibly store a substantial amount of Zn2+ ions without damaging the original crystal structure, is still a major challenge for the practical application of ZIBs. It has already been demonstrated that δ-MnO2 is a promising cathode for AZIBs owing to its layered structure and superior electrochemical performance; however, the reported results are still unsatisfactory (especially cyclability). Thus, using an oil bath method, we have fabricated a δ-MnO2 cathode that exhibits a unique mixed phase morphology of mostly spherical nanoparticles and a few nanorods. It is believed that some of the nanoparticles are agglomerated to form nanorods, which may eventually help to offer numerous active sites for Zn2+ diffusion, enhancing the electrolyte osmosis and the contact area between the electrode and electrolyte. The obtained cathode delivers a high reversible capacity of â¼204 mA h g-1 for the 100th cycle and â¼75 mA h g-1 over 1000 cycles at a high current density of 3000 mA g-1 with stable long-range cycling. Ex situ results indicate the mechanism of formation of ZnMn2O4 during discharge, followed by the evolution of the layered δ-MnO2 during charge.
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Background: Impaction of morselized allograft is an appealing procedure for addressing the bone defects. However, concerns remain about its suitability for massive defects. We used a novel "sandwich" technique by impacting the morselized allograft in layers with an intervening layer of injectable bone graft substitute for restoring bone defects during acetabular reconstruction in total hip arthroplasties. Methods: From August 2015 to June 2017, 17 revisions, 4 rerevisions, and 3 complex primary total hip arthroplasties were operated by this novel technique. Postoperatively, serial X-rays were evaluated at regular intervals. Clinical and functional outcomes were assessed by the Harris hip score. To examine if introducing an injectable bone substitute into allograft stock increased its load-bearing capability, simulated mechanical testing using Synbone samples was conducted in the laboratory. Results: The mean Harris hip score significantly improved from 54.6 preoperatively to 86.8 at the latest follow-up. Graft incorporation was seen in all the cases. There was no evidence of component migration or loosening as compared to the X-rays at 3 weeks and 3 months in all the cases. With revision of component as end point, the survivorship was 100% at 82 months. The mechanical testing reported a higher capability of allograft samples when compared to those without bone substitutes. Conclusions: Our data confirms that the use of the "sandwich" technique is a reliable option for major acetabular reconstruction. Early weight bearing is a significant value addition, and short-term results confirm good clinical and functional outcome. Longer follow-up is necessary to assess the status of the construct in the long term.
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Platinum nanoparticles (Pt NPs) have numerous applications in various sectors, including pharmacology, nanomedicine, cancer therapy, radiotherapy, biotechnology and environment mitigation like removal of toxic metals from wastewater, photocatalytic degradation of toxic compounds, adsorption, and water splitting. The multifaceted applications of Pt NPs because of their ultra-fine structures, large surface area, tuned porosity, coordination-binding, and excellent physiochemical properties. The various types of nanohybrids (NHs) of Pt NPs can be fabricated by doping with different metal/metal oxide/polymer-based materials. There are several methods to synthesize platinum-based NHs, but biological processes are admirable because of green, economical, sustainable, and non-toxic. Due to the robust physicochemical and biological characteristics of platinum NPs, they are widely employed as nanocatalyst, antioxidant, antipathogenic, and anticancer agents. Indeed, Pt-based NHs are the subject of keen interest and substantial research area for biomedical and clinical applications. Hence, this review systematically studies antimicrobial, biological, and environmental applications of platinum and platinum-based NHs, predominantly for treating cancer and photo-thermal therapy. Applications of Pt NPs in nanomedicine and nano-diagnosis are also highlighted. Pt NPs-related nanotoxicity and the potential and opportunity for future nano-therapeutics based on Pt NPs are also discussed.
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Anti-Infecciosos , Antineoplásicos , Nanopartículas Metálicas , Neoplasias , Humanos , Platina/química , Nanopartículas Metálicas/toxicidade , Nanopartículas Metálicas/química , Óxidos/química , Neoplasias/tratamento farmacológicoRESUMO
The discontinuous interfacial contact of solid-state polymer metal batteries is due to the stress changes in the electrode structure during cycling, resulting in poor ion transport. Herein, a rigid-flexible coupled interface stress modulation strategy is developed to solve the above issues, which is to design a rigid cathode with enhanced solid-solution behavior to guide the uniform distribution of ions and electric field. Meanwhile, the polymer components are optimized to build an organic-inorganic blended flexible interfacial film to relieve the change of interfacial stress and ensure rapid ion transmission. The fabricated battery comprising a Co-modulated P2-type layered cathode (Na0.67Mn2/3Co1/3O2) and a high ion conductive polymer could deliver good cycling stability without distinct capacity fading (72.8 mAh g-1 over 350 cycles at 1 C), outperforming those without Co modulation or interfacial film construction. This work demonstrates a promising rigid-flexible coupled interfacial stress modulation strategy for polymer-metal batteries with excellent cycling stability.
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Revision of an intrapelvic migration of the acetabular component of a total hip is a challenging surgery due to the risk of injury to the pelvic viscera. The primary concern is vascular injury due to the risk of mortality and limb loss. The researchers present one case where the acetabular screw was near the posterior branch of the internal iliac artery. A Fogarty catheter was placed in the internal iliac artery preoperatively, and the amount of fluid to inflate the catheter and completely block the artery was determined. The catheter was kept in a deflated condition. The hip reconstruction was performed, and there was no incidence of vascular injury during the procedure; hence, the Fogarty catheter was removed postsurgery. The placement of a Fogarty catheter in the at-risk vessel provides the freedom to proceed with the hip reconstruction through the standard approach. In case of an inadvertent event of a vascular injury, it can be inflated with the predetermined amount of saline to check the bleeding until the vascular surgeons take over the case.
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Study Design: A retrospective cohort study. Purpose: To compare the outcomes of anterior decompression with bone grafting alone and anterior decompression with bone grafting and fixation. Methods: 93 patients with minimum 2 year follow-up were included in the study. 50 patients had undergone anterior decompression with bone grafting without instrumentation (group 1) and 43 patients with instrumentation (group 2). Both groups were compared using their demographic data, vertebral level of involvement, neurological recovery and progression of kyphotic deformity. Results: Demographic data and pre-operative parameters were comparable in both groups. The mean (SD) of pre-operative kyphotic angle (in degrees) in group 1 was 29° (8.47°) and in group 2 was 29.81° (9.51°). The mean loss of correction at follow-up was 9.6° for group 1 compared to 3.4° for group 2. The mean loss of correction in patients of group 1 involving upper thoracic spine was 5.6°. There was no significant difference between the two groups across different age groups. Conclusion: Use of anterior instrumentation for decompression surgeries in cases of tubercular spine have shown significantly better results compared to strut grafting alone with respect to restricting the progression of kyphotic deformity at follow-up. Instrumentation may be avoided in patients older than 60 years of age and those involving the upper thoracic spine, more so if both of these co-exist. However, further studies are needed to make our patient selection more rational, so as to avoid the failures and complications of this morbid procedure. Supplementary Information: The online version contains supplementary material available at 10.1007/s43465-023-00827-4.
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PURPOSE: Proximal tibia stress fractures present a challenge when performing total knee arthroplasty (TKA) in knee arthritis (KA). The literature on treatment modalities for stress fractures with arthritis is varied and not systematically reviewed. We aimed to answer the questions: (1) Is long-stem TKA sufficient for stress fractures in arthritic knees? (2) Should stress fracture and KA be addressed simultaneously? (3) What is the role of augmentative procedures in stress fractures with knee arthritis? (4) Can a unified algorithm be established? METHODS: The PubMed and Cochrane databases were searched for keywords such as stress fracture, knee arthritis and total knee arthroplasty, published from January 1995 to 29 May 2022. A total of 472 records were screened down to 13 articles on the basis of our selection criteria. Ten data items were recorded from the included studies. The methodological index for non-randomised studies (MINORS) score for the included studies was 17 ± 3. RESULTS: We found long-stem TKA to be sufficient for most cases and advocated for single-stage treatment of stress fractures and arthritis. Augmentative procedures play a role in the treatment, and a unified algorithm was drafted to guide treatment. CONCLUSION: Single-stage management of advanced KA with a stress fracture causes less morbidity than a staged procedure. Long-stem TKA, with or without an augmentative procedure, is an excellent option.
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Nucleic acids (DNA and RNA) hold great potential for the advancement of future medicine but suffer from unsatisfactory clinical success due to the challenges accompanied with their delivery. Nucleic acid-mediated nanomaterials have riveted the researchers from the past two decades and exhilarating tasks have prevailed. Nucleic acid nanotechnology offers unique control over the shape, size, time, mechanics and anisotropy. It can transfect numerous types of tissues and cells without any toxic effect, minimize the induced immune response, and penetrate most of the biological barriers and hence it reveals itself as a versatile tool for multidisciplinary research field and for various therapeutic purposes. Nucleic acid combines with other nanoscale objects also by altering the chemical functional groups and reproducing the varied array of nanomaterials. Interestingly, nucleic acidderived nanomaterials are characterized easily at atomic level accuracy. However, this advent of nanoscience has vital issues which must be addressed, such as the high cost of nucleic acids, their self-assembly nature, etc. Hence, the aim of this review is to highlight the systematic advances and methodology of nucleic acid-mediated synthesis of nanomaterials and their therapeutic applications.
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Nanoestruturas , Ácidos Nucleicos , Ácidos Nucleicos/uso terapêutico , DNA/química , Nanotecnologia/métodos , Nanoestruturas/uso terapêutico , Nanoestruturas/química , Preparações FarmacêuticasRESUMO
In this study, V5+ doped sodium titanate nanorods were successfully synthesized by a sol-gel method with different optimized vanadium concentrations. Before testing as a promising anode material for sodium ion battery (SIB) application, the samples were systematically characterized. It was clearly observed that V5+ doping significantly affects the phase formation of sodium titanate samples and leads to the alteration of the major phase of Na2Ti3O7 to a single Na2Ti6O13 phase with increasing doping concentrations. Electrochemical investigations clearly showed that the optimized 15 wt% V5+ doped sample exhibits the highest capacity of 136 mA h g-1 at 100 mA g-1 after 900 cycles as well as better rate capability than the undoped sample by delivering 101 mA h g-1 capacity at a high current density of 1000 mA g-1. It is believed that the incorporation of highly charged V5+ in sodium titanate produces oxygen vacancies along with partial reduction of Ti4+ to Ti3+, resulting in improved electronic conductivity. The utilization of oxygen vacancies also preserves the integrity of the electrode, giving rise to long term cycling. Thereby, V5+ doping was found to be an effective strategy to enhance the electrochemical performance of the sodium titanate anode for SIBs.
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The present work demonstrated a novel Cleome simplicifolia-mediated green fabrication of nickel oxide nanoparticles (NiO NPs) to explore in vitro toxicity in Bm-17 and Labeo rohita liver cells. As-fabricated bioinspired NiO NPs were characterized by several analytical techniques. X-ray diffraction (XRD) revealed a crystalline face-centered-cubic structure. Fourier transform infrared spectroscopy (FTIR), ultraviolet-visible diffuse reflectance spectroscopy (UV-DRS), Raman spectroscopy, and X-ray photoelectron spectroscopy (XPS) confirmed NiO formation. The chemical composition was confirmed by energy-dispersive X-ray spectroscopy (EDS) and X-ray photoelectron spectroscopy. Brunauer-Emmett-Teller (BET) revealed the mesoporous nature. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) revealed the formation of 97 nm diameter nanospheres formed due to the congregation of 10 nm size particles. Atomic force microscopy (AFM) revealed the nearly isotropic behavior of NiO NPs. Further, a molecular docking study was performed to explore their toxicity by binding with genetic molecules, and it was found that the docking energy was about -9.65284 kcal/mol. On evaluating the in vitro toxicity of NiO NPs for Bm-17 cells, the study showed that when cells were treated with a high concentration of NPs, cells were affected severely by toxicity, while at a lower concentration, cells were affected slightly. Further, on using 50 µg/mL, quick deaths of cells were observed due to the formation of more vacuoles in the cells. The DNA degradation study revealed that NiO NPs are significantly responsible for DNA degradation. For further confirmation, trypan blue assay was observed for cell viability, and morphological assessment was performed using inverted tissue culture microscopy. Further, the cytotoxicity of NiO NPs in L. rohita liver cells was studied. No toxicity was observed at 1 mg/L of NiO NPs; however, when the concentration was 30 and 90 mg/L, dark and shrank hepatic parenchyma was observed. Hence, the main cause of cell lysis is the increased vacuolization in the cells. Thus, the present study suggests that the cytotoxicity induced by NiO NPs could be used in anticancer drugs.
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OBJECTIVE: To evaluate the clinical and functional outcomes of joint preservation surgery in high-grade giant cell tumors (GCT) around the knee joint. METHODS: A retrospective review of 25 patients of high-grade GCT (Campanacci grade 2 and 3) involving proximal tibia or distal femur managed by extended curettage, bone grafting, and stabilization with knee spanning external fixator between 2016 and 2018 was done. The radiographic outcomes, functional outcomes (Musculoskeletal Tumor Society [MSTS] score for lower limb), and complications including donor site morbidity were evaluated. RESULTS: The mean age of the patient population was 24.04 years with an average follow-up period of 30.24 months. Fourteen patients had involvement of distal femur, and 11 involved proximal tibia. There were 16 cases of grade 2 lesions and 9 cases of grade 3 lesions. Twenty-four out of the 25 patients had radiological consolidation of graft, while one patient had graft subsidence. Twenty-two out of 25 patients had full extension and knee flexion more than 100 degrees. The mean MSTS score was 25.2. Three patients had an MSTS score under 20. All three patients had an extension lag with a restricted range of motion. CONCLUSION: Joint preservation surgery, when done in line with the basic principles of tumor surgery, gives good radiographic and functional outcomes even in grade 2 and 3 giant cell tumors of bone around the knee and should be attempted before replacement surgeries.
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Introduction Most surgeons prefer a single implant for segmental proximal and diaphyseal femur fractures, although results are controversial and still no consensus for proper management is present. This prospective study analyses the functional and radiological outcome of managing 17 patients with ipsilateral shaft and proximal femur fractures by dual implant osteosynthesis at our center. Methods Over a two-year period, we managed 17 patients with a mean age of 35 years, with cancellous cannulated screws or dynamic hip screws for intracapsular femur fractures and improvised proximal femoral nail for extracapsular proximal femur fractures. Distal femoral locking plates or distal femoral nails were used for shaft femur fractures depending upon fracture morphology. The patients had a maximum follow-up of 18 months. Results A total of 80% of patients had a good functional outcome (using the Friedman-Wyman scoring system) while 60% had an excellent Harris Hip Score. The mean time taken for the bone union for proximal femur fractures was 4.75 months and for shaft femur fractures, it was 6 months. Conclusion We had a satisfactory functional and clinical outcome of managing these fractures with two implants, one focusing biomechanically on each fracture. This principle of dual implant osteosynthesis can reliably be used in such difficult fracture patterns and it negates the use of the single cephalomedullary nail for fixating both fractures.