Surgical Treatment for Ipsilateral Fractures of Femoral Neck and Shaft

Objectives: To review the primary and the final results of surgical management of ipsilateral femoral neck and shaft fractures. Subjects and Methods: Seventeen patients (2 female, 15 male, average age 37 years, range 20–60) with ipsilateral femoral neck and shaft fractures were treated by compression plate fixation for the femoral shaft fractures and dynamic hip screw or cannulated cancellous screw fixation for the neck fractures in Al-Razi and Al-Jahra Hospitals, Kuwait, from March 1996 to June 2002. The clinical and radiological primary and final results were analyzed retrospectively. Results: The average follow-up for the primary outcomes was 3.6 years (range 2–6 years). 100% union of the femoral neck fractures, 0% osteonecrosis of the femoral head and 77% union of the shaft fractures were achieved. Complications of femoral shaft fractures, nonunion and metal failure, occurred in 4 (23%) patients and postsurgical infection occurred in 1 patient. At the final follow-up, 15 (88%) patients achieved good clinical outcome and 2 (12%) had fair outcome. Conclusion: Our results show that compression plate fixation for the femoral shaft fracture and dynamic hip screw or cannulated screw fixation for the neck fracture in combination injury is a reliable and adequate technique.