Surgical Treatment for Ipsilateral Fractures of the Hip and Femoral Shaft

Objective To evaluate the clinical features and treatment methods of femoral shaft fractures incorporated with ipsilateral femoral neck fractures.Methods From May 2001 to September 2008,14 cases of ipsilateral fractures of femoral neck and shaft treated with surgical reduction and internal fixation were retrospectively analyzed.There were 9 males and 5 females.The causes of fractures were as follows:13 cases of motor vehicle accidents,1 caused by fallen.In cases of the femoral shaft fracture,2 patients in proximal third,9 patients occurred in the middle third,3 patient in distal third.According to Garden classification for femoral neck fractures,there were 8 stage Ⅱ,5 stage Ⅲ,and 1 stage Ⅳ.There were 3 open fractures.The femoral shaft and neck fractures were stabilized with reconstruction interlocking nail in 4,with cannulated lag screws and retrograde interlocking intramedullary nail in 8,with dynamic hip screw system(DHS) in 2.Results The average duration of the follow-up was 18 months(range,10 months to 5 years).The femoral neck fracture was initially overlooked in 3 cases(21.4%).Mean time for union of the femoral neck fracture was 16 weeks(ranging 12 to 19 weeks) for the femoral shaft fracture was 18 weeks(ranging 14 to 22 weeks).No severe complications were observed during the follow-up period.Conclusion In case of femoral shaft fracture resulted from high-energy trauma,diagnostic imaging should be taken,which can effectively avoid or minimize miss diagnosis.Complex ipsilateral femoral neck and shaft fractures should be timely surgical treated through rational and reliable internal fixation,which can attain early satisfactory clinical results.