Diagnosis and treatment of the femoral shaft fractures combined with ipsilateral occult femoral neck fractures / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To improve the ability of recognizing, diagnosing and treatment for the femoral shaft fractures combined with ipsilateral occult femoral neck fractures, and reduce the rate of loss-diagnosis.</p><p><b>METHODS</b>By retrospective study of 50 patients who sustained ipsilateral femoral shaft and neck fractures from March 1998 to October 2003, 9 cases were femoral shaft fractures combined ipsilateral femoral neck fractures. The neck fractures were diagnosed separately before, during and after operation. Among the 9 cases, 5 cases treated with reconstructive intramedullary nail to fix both shaft and neck fractures; 3 cases were treated with retrograted intramedullary nail to fix shaft fractures and with canulated screws to fix neck fractures; another one was sustained two operations, after the fixation of shaft by intramedullary nail, the neck fracture was found, the neck fracture was fixed with canulated screws anterior and posterior of the nail.</p><p><b>RESULTS</b>Nine cases were followed up for average 20 months. All femoral shaft fractures were united during 6 months; and all neck fractures were united during 3 months.</p><p><b>CONCLUSIONS</b>Femoral shaft fractures combined with ipsilateral occult femoral neck fractures have a high rate of loss-diagnosis during the early stage after injure, the orthopaedic surgeons should consider the femoral neck fracture by analyzing the mechanism of high energy injury patient with femoral shaft fracture. The occult femoral neck fractures can be diagnosed by CT scan before operation. During and after the operation of fixing the femoral shaft fractures, the femoral neck should be observed intensively to identify the exist of fractures.</p>