Ipsilateral simultaneous femoral shaft and femoral neck fracture: valuable diagnostic signs

ABSTRACT

When fractures of both shaft and neck occur in the same femur the neck fracture is often missed; this may lead to complications such as avascular necrosis and non-union. Management of this fracture combination can be successful provided the diagnosis is made early. This paper is presented to demonstrate valuable diagnostic signs to avoid missing the femoral neck fracture; it is based on a clinical and radiological study of 8 patients with this fracture combination. The presence of an associated femoral neck fracture should be suspected if there is fullness and tenderness in the groin or over the greater trochanter of the affected limb. Radiologically, medial displacement of the proximal fragment of a transverse fracture of the shaft is almost always diagnostic of the associated hip injury