Ipsilateral Fractures of Femoral neck and Shaft

Kim, Byeong Hwan; Sohn, Sung Keun; Park, Soo Jin

Abstract

Ipsilateral fractures of the femoral neck and shaft are uncommon injuries with the difficulties in diagnosis and treatment. The femoral neck fracture of this injury is commonly missed on initial evaluation. The overlooked femoral neck fracture may lead to higher risk of complications such as avascular necrosis of the femoral head, nonunion and coxa vara. The authors reviewed nine cases of ipsilateral femoral neck and shaft fracture treated in our clinic from June 1990 to March 1997, and average follow-up period was 39 months(range, 16 to 97 months). The results obtained were as follows ; 1. The cause of injury was traffic accident and one femoral neck fracture was missed initially. 2. The most common site of femoral neck fracture was basicervical in 7 cases and that of shaft fractures was middle 1/3 shaft in 6 cases. 3. Two cases were treated with femoral reconstruction nail, seven with multiple neck pinning and dynamic compression plate for shaft fracture. 4. There were complication such as 2 cases of delayed union of femoral shaft, 1 case of nonunion of femoral shaft. 5. It should be treated with anatomical and rigid internal fixation in femoral neck fracture having first priority.