Surgical Treatment for Ipsilateral Fractures of Femoral Neck and Shaft

Khallaf, Fathy G.; Almosalamy, M. H.; Al-Akkad, M.; Hantira, H.

doi:10.1159/000086929

Cited by 20 publications

(14 citation statements)

References 23 publications

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“…Other series reported 2 to 6% of patients developed deep infection. 16,17 In our series, no avascular necrosis of the femoral head occurred, consistent with a lower incidence among patients with ipsilateral femoral neck and shaft fractures than in solitary femoral neck fractures (3% vs 10%). 14,18 Compared to other techniques, fixation using a DCP and a DHS for ipsilateral femoral neck and shaft fractures is a reliable means of achieving bone union with few complications.…”

Section: Discussionsupporting

confidence: 86%

“…It achieves a union rate of 77 to 93% in the femoral shaft and 93 to 100% in the femoral neck, with 77 to 93% of patients achieving good outcomes. 6,16,17 A high incidence of infection was reported after plating for femoral shaft fractures. 4,9 In our series, 2 (5%) patients developed deep infection, which resolved after debridement and antibiotic treatment.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 86%

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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“…Though recent literature shows favourable results with the use of a single implant i.e., reconstruction type of intramedullary nail, we are of the opinion that treating these combination of fractures with two separate devices (plate-screw combinations) does have a role. [7][8][9][10][11][12][13][14][15] In this study we compared the outcome of ipsilateral hip and shaft femur fractures treated with reconstruction-type intramedullary nailing and various plate combinations on the fracture healing and functional outcome in patients. Very few authors have compared these two methods of fixation.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11][12][13][14][15]  Various plate-screw combinations-including a dynamic hip screw (DHS) and long side plate combination, a hip screw with a short side plate for the neck and separate plate for the shaft or cancellous screws for femoral neck and a plate for the shaft. 13,14,16  Retrograde intramedullary nail of the shaft and screw fixation of the neck.…”

mentioning

confidence: 99%

Analysis of the results of ipsilateral hip and shaft femur fractures treated with reconstruction-type intramedullary nail or various plate combinations

rao

Chodavarapu

Buchupalli³

et al. 2016

Int J Res Orthop

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Background: Ipsilateral femoral shaft and hip fractures are commonly encountered following high energy trauma. Despite many treatment methods, controversy exists regarding the optimal management of these fractures. This study was planned to compare reconstruction-type intramedullary nailing and various plate combinations on the fracture healing and functional outcome in patients with these fractures.Methods: 25 patients with ipsilateral femoral shaft and hip fractures were operated by one of the two modalities - cancellous lag screws or dynamic hip screw for fracture hip and compression plate fixation for fracture shaft of the femur (Group I, 13 patients) and Reconstruction-type intramedullary nailing alone (Group II, 12 patients) - depending on surgeon's preference. The functional results of the patients were assessed with the system used by Friedman and Wyman. Radiological and functional assessment was done by an independent evaluator blinded to the surgical procedure.Results: The mean age was 33.6±4.03 in group I and 35.3±4.04 years in group II (p=0.70). The average follow up was 15 months. The average union time for femoral neck fracture was 15.75±0.89 and 16.48±1.40 (p=0.36) weeks and for fracture shaft was 19.27±1.18 and 20.06±1.16 (p=0.15) in group I and group II respectively. 10 patients (76.9%) in group I and 9 (75%) in group II showed good functional results. Two patients needed re-operation in group I and one patient in group II.Conclusions: Ipsilateral femoral shaft and hip fractures can be treated satisfactorily either with nailing alone or various plate combinations with similar outcome.

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“…12,25 However, separate device fixation, while being associated with fewer reoperations, 25 is also associated with infection and nonunion. 26…”

Section: Introductionmentioning

confidence: 99%

Single versus separate implant fixation for concomitant ipsilateral femoral neck and shaft fractures: A systematic review

Mohan¹,

Ellanti²,

French³

et al. 2019

Orthop Rev (Pavia)

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Concomitant ipsilateral femoral neck and shaft fractures are uncommon, occurring in 1-9% of femoral shaft fractures. While this injury typically occurs in young patients following high-energy trauma, little consensus has been established regarding the optimal fixation approach. A multitude of treatment strategies exist, with limited evidence as to which is more favorable. The aim of this study was to appraise current evidence, comparing management with either one single or separate devices for both fractures. A systematic review was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies published between 1992 and 2018 comparing the rate of postoperative nonunion, malunion, delayed union, avascular necrosis, infection or reoperation between at least one method of single device fixation and one method of separate device fixation were included. Six non-randomized cohort studies assessing 173 patients were suitable for inclusion, each comparing single device cephalomedullary nail fixation of both fractures with a combination of devices. All patients presented following high-energy trauma, at a median age of 32 years. While low complication rate and favorable outcomes were found across both groups, no significant difference could be inferred between either treatment strategy. This injury continues to occur in the traditionally described patient group, and results in acceptable postoperative outcomes. A paucity of randomized studies limits the ability to recommend a single or separate device treatment approach, and as such prospective, randomized trials with adequately powered sample sizes are required to definitively compare surgical management strategies in this rare but complex injury.

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Surgical Treatment for Ipsilateral Fractures of Femoral Neck and Shaft

Cited by 20 publications

References 23 publications

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

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

Analysis of the results of ipsilateral hip and shaft femur fractures treated with reconstruction-type intramedullary nail or various plate combinations

Single versus separate implant fixation for concomitant ipsilateral femoral neck and shaft fractures: A systematic review

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