J Korean Fract Soc.  2011 Oct;24(4):307-312.

Clinical Outcome of Surgical Treatment for Fracture of the Femoral Shaft with Ipsilateral Fracture of the Proximal Femur

• Park HG
• Yoo JS

Abstract

PURPOSE
To analyze diagnostic process and clinical data in cases of fracture of the femoral shaft with fracture of the proximal femur.
MATERIALS AND METHODS
We reviewed 24 cases of patient who undergone surgery for fracture of the femoral shaft with ipsilateral fracture of the proximal femur and more than 1 year of examination of follow up was available. Age, sex.location and classification of the fracture, the time of diagnosis and operation, the method of operation, the associated injuries, the time of bony union and complication were investigated, postoperative function was evaluated on Friedman and Wyman criteria.
RESULTS
Bony union showed significant difference in the displacement and comminution of fracture, postoperative function revealed significant difference according to the associated injuries. The 6 cases (25%) out of 24 cases are failed early diagnosis, 4 cases out of 6 cases was detected during operation and 2cases was found after surgery. 21 cases out of 24 cases of femoral shaft fractures showed union, 23 cases out of 24 cases of femoral neck fractures showed union. There were eleven good, eleven fair, and two poor functional result according to Friedman and Wyman criteria.
CONCLUSION
Precious clinical and radiologic examination is needed not to miss the diagnosis of proximal femur fractures in ipsilateral femoral shaft fractures with proximal femur fractures. Anatomical reduction and rigid fixation of proximal femur are important to reduce avascular necrosis of femoral head and nonunion of proximal femoral fractures.

Keyword

Femur; Femoral shaft fracture; Proximal femur fracture

MeSH Terms

Displacement (Psychology)
Early Diagnosis
Femoral Fractures
Femoral Neck Fractures
Femur
Follow-Up Studies
Head
Humans
Necrosis

Figure

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  Fig. 1 (A) Anteroposterior and lateral radiographs of femur in a 43 year-old man show femoral shaft fracture. (B) Anteroposterior and lateral radiographs of femur after operation show IM nailing fixation. (C) Anteroposterior radiograph of hip after operation shows IM nailing fixation. (D) Anteroposterior radiograph of hip after secondary operation shows multiple screw fixation.

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  Fig. 2 (A) Anteroposterior radiograph of hip in a 56 year-old man shows left femoral shaft with intertrochanter fracture. (B) Anteroposterior radiograph of hip after operation shows plate and dynamic hip screw fixation. (C) Anteroposterior radiograph of hip 6 months after operation shows nonunion of intertrochanter fracture. (D) Anteroposterior radiograph of hip after secondary operation shows total hip replacement arthroplasty.

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