Ipsilateral Femoral Shaft and Neck fracture

Lee, Dong Chul; Lee, Yun Seok; Shin, Duk Seop

Abstract

The occurrence of ipsilateral hip and femoral shaft fracture is uncommon and this problematic combination occur in 2.5% to 6% of femoral fracture. This combination of fractures result from high energy trauma and occurs in young multiply injured patient. As most orthopedists attention is directed to the shaft fructure of femur, the neck fracture can be commonly missed initially. Ipsilateral femoral shaft and neck fracture has the characteristics that has multiple associated injuries and many complications, such at avascular necrosis and nonunion of the femur neck, coxa vara. We analysed the outcome of treatment to know the results of treatment and its complication in 10 patients who were treated at Orthopedic Department, Yeungnam University Hospital from May 1991 to May 1996. The results were as follows : 1. Sixty percent of femoral neck fracture was basicervical type; Ninty Percent of femoral shaft fracture occured in the middle one third and most of the fractures were comminuted. There was one open fracture of femoral shaft. 2. All of the causes of the fractures occurred in motor vehicle accident. Mean age was 40.3 years(range: 15-59 years). There were 24 associated injuries in ten patients: especially, the injuries around knee were most common(6 tibial condylar fractures, 3 patellar fractures, 1 ligament injuries). 3. The bone union was obtained at average 2.8 months after operation(2 months - 5 months) in femur neck fractures, at average 5.5 months after operation(4 months - 12 months) in femur shaft fractttres and weight hearing was permitted at average 2.3 months after operation(1.5 months - 5 months). 4. There were 3 cases of nonunion of femoral shaft fracture, but they were treated by autogenous iliac bone graft Early bone graft may be necessary in comminuted femoral shaft fracture.