Ipsilateral Acetabular and Femoral Neck and Shaft Fractures

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Abstract

Floating hip injuries and ipsilateral femoral neck and shaft fractures are rare. Additionally, the simultaneous occurrence of these injuries is extremely rare, and only one case report of the simultaneous occurrence of these injuries has been published. Here, we report the case of a patient with ipsilateral acetabular and femoral neck and shaft fractures following a suicide attempt. The patient experienced nonunion of the femoral neck and shaft after the initial operation and therefore underwent reconstruction using a femoral head prosthesis with a long stem and interlocking screws. Our procedure may be used in primary and/or secondary reconstruction for ipsilateral acetabular and femoral neck and shaft fractures.

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Most cited references 12

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The floating hip injury: patterns of injury.

M Liebergall, R Mosheiff, O Safran … (2002)

To evaluate the relationship between mechanism of injury, type of femoral fracture and type of acetabular fracture in floating hip injury.

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Cephalomedullary interlocked nail for ipsilateral hip and femoral shaft fractures.

Pankaj Jain, Lalit Maini, Puneet Mishra … (2004)

A retrospective study of the management of 23 cases of ipsilateral hip and femoral shaft fractures, between January 1998 and December 2001, is presented. All except two cases were managed by a single implant, i.e. reconstruction nail. There was delayed diagnosis of femoral neck fracture in two cases where the "miss a nail" technique was used for fixation of the femoral neck fracture. All patients managed by reconstruction nail were simultaneously operated on for both fractures and operative treatment was executed as early as the general condition of the patient permitted. Delay in treatment was generally because of the associated injuries (head, chest or abdominal). There were 22 males and 1 female patient with an average age of 34.5 years. Average follow-up was 30.9 months. There was one case of non-union of the femoral neck fracture, one case of avascular necrosis and one femoral neck fracture united in varus. There were four cases of non-union and six cases of delayed union of femoral shaft fractures. Mean time for union of the femoral neck fracture was 15 weeks and for the shaft fracture was 22 weeks. In this series femoral shaft fracture determined the total union period. Complications involving the femoral shaft fracture were more common than those related to femoral neck fractures. Shaft complications were more manageable with or without secondary procedures as compared to femoral neck complications, which usually require more extensive procedures. This stresses the need to realise the significance and seriousness of both components of this complex injury, in evaluation, management and post-operative care. We conclude that, though technically demanding, reconstruction nail is an acceptable alternative for management of concomitant fractures of the femoral neck and shaft with acceptable rates of complications and good results.

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Retrograde nailing with subsequent screw fixation for ipsilateral femoral shaft and neck fractures.

Hee Soo Kyung, Jong-Keon Oh, Yoon Kim … (2006)

Although ipsilateral femoral shaft and neck fractures are difficult to treat, there is still no consensus on the optimal treatment of this complex injury. We report the results of treating the 17 fractures with a standard protocol of retrograde nailing for diaphyseal fractures and subsequent screw fixation for the femoral neck fractures. Seventeen injuries (16 patients) sustained femoral shaft fractures, which were treated with retrograde intramedullary nails and subsequent screw fixation. Femoral neck fracture was noted before the operation in all patients except one. A femoral shaft fracture was always addressed first with unreamed retrograde nailing. Then, the femoral neck fracture was treated by cannulated screws or dynamic hip screw according to the level of fracture. The average time for union of femoral shaft fractures was 27.3 (14-60) weeks. Nonunion occurred in five patients, who required bone grafts or changes of fixation. The average time for union of femoral neck fractures was 11 (8-12) weeks. All united, except for one case of nonunion with avascuar necrosis, which was a Garden stage IV fracture. Functional results using Friedman-Wyman criteria were good in 16 cases, and fair in one. The only fair result was nonunion of the femoral neck, which had the joint arthroplasty. Retrograde nailing of femoral shaft fractures can provide an easy fixation and a favorable result for ipsilateral femoral neck fractures.

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Author and article information

Journal

Journal ID (nlm-ta): Case Rep Orthop

Journal ID (iso-abbrev): Case Rep Orthop

Journal ID (publisher-id): CRIOR

Title: Case Reports in Orthopedics

Publisher: Hindawi Publishing Corporation

ISSN (Print): 2090-6749

ISSN (Electronic): 2090-6757

Publication date (Print): 2015

Publication date (Electronic): 10 June 2015

Volume: 2015

Electronic Location Identifier: 351465

Affiliations

¹Department of Emergency Medicine, Advanced Critical Care and Emergency Center, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo 060-8543, Japan

²Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo 060-8543, Japan

Author notes

*Hideto Irifune: irifuneh@ 123456sapmed.ac.jp

Academic Editor: Nikolaos K. Kanakaris

Article

DOI: 10.1155/2015/351465

PMC ID: 4478406

PubMed ID: 26171267

SO-VID: 1cf0cf84-f673-42d1-951f-4fa65a22bdd5

License:

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 6 February 2015

Date accepted : 4 June 2015

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Ipsilateral Acetabular and Femoral Neck and Shaft Fractures

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Abstract

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Orthopedics

Most cited references 12

The floating hip injury: patterns of injury.

Cephalomedullary interlocked nail for ipsilateral hip and femoral shaft fractures.

Retrograde nailing with subsequent screw fixation for ipsilateral femoral shaft and neck fractures.

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