The Journal of Bone and Joint Surgery, Vol 61, Issue 4 503-509, Copyright © 1979 by Journal of Bone and Joint Surgery, Inc
Ipsilateral concomitant fractures of the hip and femoral shaft
MJ Casey and MW Chapman
Fifty-two cases of concomitant ipsilateral fractures of the hip and femoral
shaft were reviewed from the literature and twenty-one of our own were
added. Thirty-one per cent of the femoral-neck fractures reported in the
literature and one of our own were missed on initial evaluation. Examples
of non-union and aseptic necrosis were all from the previously reported
cases and occurred in the patients in whom there was a delay in diagnosis
and treatment of the fracture of the neck. Nine of our patients had
associated ipsilateral knee injuries. In nine pulmonary complications
developed, all while in skeletal traction. If the patient survived the
initial injury, the prognosis was surprisingly good. We concluded that
intracapsular hip fractures should be treated by internal fixation. Good
long-term results were the rule in the diaphyseal fractures. Internal
fixation of both fractures should be considered in patients with severe
multisystem trauma, in the very elderly, and in those with ipsilateral knee
injuries. Ender pins were useful and were employed in five of our patients.