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Femoral Neck-Shaft Fracture

  • Treatment of ipsilateral femoral neck and femoral shaft fractures remains controversial.
  • Generally treated with reduction and cannulated screw fixation of the femoral neck fracture followed by retrograde femoral nailing. Other options include antegrade cepholomedullary nail, DHS, etc.
  • Non-displaced femoral neck fractures should be treated with cannulated screw fixation before femoral shaft treatment to avoid displacement of the femoral neck facture during shaft fixation.
  • Cephalomedullary device alone is associated with a higher malreduction rate of either the shaft or neck component and increased rates of nonunion or malunion.

Femoral Neck-Shaft Review References

  • Watson JT, CORR 2002;399:78
  • Wolinsky PR, Johnson KD: Ipsilateral femoral neck and shaft fractures.  Clin Orthop 1995;318:81-90.
  • Bedi A, Karunakar MA, Caron T, Sanders RW, Haidukewych GJ. Accuracy of reduction of ipsilateral femoral neck and shaft fractures--an analysis of various internal fixation strategies. J Orthop Trauma. 2009 Apr;23(4):249-53.
  • Peljovich AE, Patterson BM. Ipsilateral femoral neck and shaft fractures. J Am Acad Orthop Surg. 1998 Mar-Apr;6(2):106-13

 

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