IPSILATERAL NECK AND SHAFT FRACTURES OF FEMUR: RESULTS OF CEPHALOMEDULLARY NAILING FOLLOWING AN IMPROVED PROTOCOL FOR DIAGNOSIS

Abstract

Objectives: The purpose of the study is to evaluate the effectiveness of a new diagnostic protocol in identifying femoral neck fractures associated with ipsilateral shaft fractures and to study the clinical and functional outcome of these patients treated by cephalomedullary nailing.

Materials and Methods: 268 consecutive patients with presenting with 273 femoral shaft fractures were subjected to AP radiographs of the ipsilateral hip along with clinical examination for neck tenderness and aspiration of the ipsilateral hip to rule out an associated neck fracture. Computerized tomography scans through the femoral neck was taken only in case of discrepancy in the initial work up. All patients diagnosed to have an associated neck fracture underwent surgical stabilization using long cephalomedullary nails.

Results: All 28 neck fractures occurring in association with 273 consecutive femoral fractures were diagnosed without delay. Computerized tomography scans were required in 8 patients. All fractures united at follow up and good functional results were obtained in 19 of the 25 patients included in the final analysis.

Conclusion: Neck fractures associated with ipsilateral femoral shaft fractures can be diagnosed without the need for higher imaging modalities on a routine basis. Fixation of both fractures with a long cephalomedullary nail gives good results with minimal complications.