Concomitant ipsilateral intracapsular and extracapsular femoral neck fracture: a case report

Abstract

Introduction: Intracapsular and extracapsular hip fractures are common amongst elderly patients but simultaneous intracapsular and extracapsular hip fractures are rare.

Ipsilateral femoral neck and trochanter fracture

“…Of the cases reported in the literature, five cases were apparent at initial radiographic evaluation,468–10 three were confirmed on further imaging preoperatively,357 two were identified by fluoroscopy during surgical procedure,12 while one was identified in a postoperative period 11. In our case, the preliminary examination of the anteroposterior radiograph did not reveal the presence of a fracture line in the femoral neck region.…”

“…There are 11 reports in the medical literature of ipsilateral fractures of the femoral neck and intertrochanteric--pertrochanteric region 1–11. Of these, eight cases are reported in elderly osteoporotic patients following a fall 1–8.…”

“…The presence of this combination injury presents additional technical difficulties in attempted osteosynthesis 10. In one of the cases, the subcapital femoral neck fracture was missed preoperatively and during the insertion of the DHS screw, rotation of the femoral head might have occurred with an interruption in blood supply resulting later in avascular necrosis 11. A sliding hip screw is the most commonly used implant for the fixation of intertrochanteric fractures 12.…”

“…Occurrence of simultaneous ipsilateral fracture of the femoral neck and trochanteric region is rare 1–11. Eleven cases are described in the English language literature and 65% of these have occurred in elderly with osteoporotic bones following a fall 1–8.…”

A retrospective cohort study of concomitant ipsilateral extra-capsular and intra-capsular fractures of the proximal femur. Are they casual findings or an undervalued reality?

“…The combination of both fracture patterns in elderly patient is considered to be very rare and scientific references are extremely scarce, with most references appearing as case reports [6][7][8][9][10][11][12][13][14][15]. To our knowledge, the association of both fractures in osteoporotic bone, as a result of low energy trauma, was described thirty years ago in a case report [6,7], and the only series (29 cases of extra-capsular fractures associated with femoral neck fracture) of these rare fractures in proximal femur was drawn up a decade ago [16], reporting an incidence of 7.5% (29 out of 385).…”