Ipsilateral femoral neck and shaft fractures. When do we need further image screening of the hip?

Marins, Murilo Humberto Tobias; Pallone, Lucas Valerio; Vaz, Breno Alves de Souza; Ferreira, Aline Miranda; Nogueira-Barbosa, Marcello Henrique; Salim, Rodrigo; Fogagnolo, Fabrício

doi:10.1016/j.injury.2021.01.040

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…These injuries are usually the result of high-energy trauma (HET) and occur mostly in polytraumatized young adults [ 10 ]. AO-type A3, AO-type B, and AO-type C femoral shaft fracture patterns are more often part of a bifocal injury [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Previous literature reports that up to 30% of femoral neck fractures are missed [ 10 , 12 ], and increased awareness showed a decline in missed fractures [ 9 , 13 ]. In bifocal fractures, the femoral shaft fracture is usually accompanied by a fracture of the femoral neck, but up to 28% is accompanied by a trochanteric fracture [ 11 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Surgical management of bifocal femoral fractures: a systematic review and pooled analysis of treatment with a single implant versus double implants

Lieshout

Verhofstad

2023

Arch Orthop Trauma Surg

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Introduction Fractures of the proximal femur accompanied by a fracture of the femoral shaft are relatively rare, with a reported prevalence between 1 and 12%. Multiple surgical options are available, consisting of treatment with a single implant or with double implants. Controversy exists about the optimal management. A systematic review and pooled analysis were performed to assess the most reliable treatment for bifocal femoral fractures of the femur. Materials and methods A literature search was conducted on July 15, 2022. Selected studies were screened on title and abstract by two researchers independently, and full texts were read by both authors. Emphasis was put on adverse events such as postoperative infection, healing complications, malalignment, and functional outcome using either a single implant or double implants. Results For the proximal femoral fractures, no significant difference could be confirmed for avascular necrosis of the femoral neck (5.1% for single implant and 3.8% for double implants), nonunion (6.4% for single implant and 7.8% for double implants), or varus malalignment (6.6% for single implant and 10.9% for double implants). This study also suggests that the number of implants is irrelevant for complications of the femoral shaft regarding the rates of postoperative infection and healing complications. Pooled rates of bone healing complications were 1.6–2.7-fold higher when patients were treated with a single implant, but statistical significance could not be confirmed. For hardware failure, revision surgery, leg length discrepancy, and functional outcome, no difference between the two groups was found either. Conclusions The pooled proportions of all postoperative complications had overlapping confidence intervals; thus, no inference about a statistically significant difference on the number of implants used for treating ipsilateral fractures of the femur can be made. Both treatment groups showed a similar functional outcome at the last moment of follow-up, with more than 75% of the patients reporting a good outcome.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgical management of bifocal femoral fractures: a systematic review and pooled analysis of treatment with a single implant versus double implants

Lieshout

Verhofstad

2023

Arch Orthop Trauma Surg

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Diaphyseal Femur Fractures

Giordano,

de Souza,

Pires

et al. 2024

Orthopaedics and Trauma

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Comparison of reconstruction nails versus dual implants in the treatment of ipsilateral femoral neck and shaft fractures in adults: a meta-analysis and systematic review

Zhao,

Li,

Liu

et al. 2023

BMC Musculoskelet Disord

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Objective There is no consensus on the optimal treatment for ipsilateral femoral neck and shaft fractures. This meta-analysis aims to assess the effectiveness of reconstruction nails and dual implants in treating ipsilateral femoral neck and shaft fractures to provide a basis for decision-making when selecting the optimal approach. Methods Relevant articles were retrieved from Pubmed, Embase, and Cochrane databases using the keywords "neck of femur", "shaft" and "fracture fixation" from inception until November 17, 2022. The screening process of the studies was conducted independently by two assessors, who assessed each study's eligibility and two assessors assessed the quality. Then compared differences in outcome measures using RevMan 5.3 software. Results A total of ten retrospective cohort studies were included. There were no significant differences in union time, union rate, union-related complications (malunion, nonunion, delayed union) of femoral neck and shaft fractures, osteonecrosis of the femoral head, and functional outcomes (Friedman-Wyman scoring system) (P > 0.05). Conclusion Our pooled estimates indicated that reconstruction nails and dual implants for ipsilateral femoral neck and shaft fractures could yield satisfactory surgical results, and that there is no difference between the two treatment methods. Trial registration This meta-analysis was registered on the PROSPERO website (registration number: CRD42022379606).

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Ipsilateral femoral neck and shaft fractures. When do we need further image screening of the hip?

Cited by 3 publications

References 28 publications

Surgical management of bifocal femoral fractures: a systematic review and pooled analysis of treatment with a single implant versus double implants

Surgical management of bifocal femoral fractures: a systematic review and pooled analysis of treatment with a single implant versus double implants

Diaphyseal Femur Fractures

Comparison of reconstruction nails versus dual implants in the treatment of ipsilateral femoral neck and shaft fractures in adults: a meta-analysis and systematic review

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