Ipsilateral proximal and shaft femoral fractures: spectrum of injury involving the femoral neck

Shuler, Thomas E.; Gruen, Gary S.; Ditano, O.; Riemer, Barry L.

doi:10.1016/s0020-1383(96)00199-4

Cited by 25 publications

(16 citation statements)

References 19 publications

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“…All the ipsilateral femoral diaphyseal fractures in this series were comminuted fractures, similar to the pattern reported by Shuler et al [5] .…”

Section: Discussionsupporting

confidence: 90%

“…This is mostly because the complications of the femoral neck fractures (nonunion and avascular osteonecrosis of the femoral head) are more diffi cult to treat, especially in young patients, who represent the main and usual victims of this complex fracture of femoral neck and shaft. Accordingly, treatment of femoral neck fractures takes precedence over the shaft fracture in most of the literature reports [5,7,10,13] . To ensure the best chance for union, the neck fracture should be reduced anatomically and fi xed rigidly by cannulated cancellous lag screws or by DHS.…”

Section: Discussionmentioning

confidence: 99%

“…They are commonly associated with other skeletal injuries, chest injuries and abdominal injuries [3,4] . Many literature reports described a specifi c pattern of femoral neck fracture, which in most instances is a vertical and nondisplaced or minimally displaced fracture that is often missed [5][6][7][8] . Numerous protocols have been recommended for the treatment of this combination injury.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Treatment for Ipsilateral Fractures of Femoral Neck and Shaft

et al. 2005

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Objectives: To review the primary and the final results of surgical management of ipsilateral femoral neck and shaft fractures. Subjects and Methods: Seventeen patients (2 female, 15 male, average age 37 years, range 20–60) with ipsilateral femoral neck and shaft fractures were treated by compression plate fixation for the femoral shaft fractures and dynamic hip screw or cannulated cancellous screw fixation for the neck fractures in Al-Razi and Al-Jahra Hospitals, Kuwait, from March 1996 to June 2002. The clinical and radiological primary and final results were analyzed retrospectively. Results: The average follow-up for the primary outcomes was 3.6 years (range 2–6 years). 100% union of the femoral neck fractures, 0% osteonecrosis of the femoral head and 77% union of the shaft fractures were achieved. Complications of femoral shaft fractures, nonunion and metal failure, occurred in 4 (23%) patients and postsurgical infection occurred in 1 patient. At the final follow-up, 15 (88%) patients achieved good clinical outcome and 2 (12%) had fair outcome. Conclusion: Our results show that compression plate fixation for the femoral shaft fracture and dynamic hip screw or cannulated screw fixation for the neck fracture in combination injury is a reliable and adequate technique.

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“…All the ipsilateral femoral diaphyseal fractures in this series were comminuted fractures, similar to the pattern reported by Shuler et al [5] .…”

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical Treatment for Ipsilateral Fractures of Femoral Neck and Shaft

et al. 2005

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“…12 The diagnosis of femoral neck fracture is easily missed if an anteroposterior radiograph of the pelvis is not taken. Therefore, patients with femoral shaft fractures should undergo thorough radiographic evaluation of the femoral head and neck (with the hip in internal rotation).…”

Section: Discussionmentioning

confidence: 99%

Dynamic Hip Screw and Compression Plate Fixation of Ipsilateral Femoral Neck and Shaft Fractures

Abalo

Dossim

Bangna

et al. 2008

J Orthop Surg (Hong Kong)

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Purpose. To evaluate surgical outcomes of ipsilateral femoral neck and shaft fractures. Methods. Between April 1997 and September 2004, 29 men and 8 women (mean age, 37 years) underwent fixation of femoral neck and shaft fractures using a dynamic compression plate plus a dynamic hip screw or screws. There were 30 femoral neck and 7 pertrochanteric fractures. Functional results were assessed according to the Friedman and Wyman classification. Results. The mean follow-up period was 49 months. Of the femoral neck fractures, 34 united in a mean of 4 months; 33 of them healed anatomically and one with a 6º varus angulation. No osteonecrosis of the femoral head was noted. Of the femoral shaft fractures, 32 united in a mean of 6 months, 5 were non-unions (2 persisted even after revision surgery). Seven patients developed infections (5 superficial and 2 deep), which resolved with debridement and antibiotic treatment. Surgery 2008;16(1):35-8 shaft fractures is reliable in achieving bone union with few complications. Journal of Orthopaedic

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“…7 Shuler et al (1997) showed a clustering of inferior fracture lines in the inferomedial femoral neck region in ipsilateral femoral neck and shaft fractures in adults. 12 Considering a similar mechanism for these injuries in children, it is suggested that for a force traveling along the femoral axis, the maximum shearing forces concentrate at cervicotrochanteric region, fracturing it. A medial comminution in the neck region is expected in such cases, partially explaining an initial coxa vara (cases 1 and 2).…”

Section: Discussionmentioning

confidence: 96%