English

Abstract

Ipsilateral femoral neck and shaft is primarily found in younger individuals, usually in their third or fourth decades. Patients are usually involved in high-energy trauma. The overall incidence of associated neck and shaft fracture ranges from 2.5% to 9%. The majority of these injuries are the result of motor vehicle accidents or falls from a height. Ipsilateral femoral neck fractures are usually nondisplaced and, therefore, difficult to diagnose. Study of twenty five cases of ipsilateral neck and shaft fractures managed by reconstruction nail is presented. Pelvic film with hips in 20 degrees of internal rotation is recommended to avoid missing the diagnosis at the initial workup of the patient .We had no patient with delayed diagnosis of neck fracture. All patients were operated as early as the general condition of the patient permitted. Delay in treatment was mainly due to associated major non orthopaedic injuries. There were 22 males and 3 female patients. Mean age in males was 40.14+/- 10.98 yrs and females was 40.33+/- 7.64yrs age. All the patients were followed up for six months of till the union of both the fractures. There were two cases of non-union of the femoral neck fracture, one case of avascular necrosis of head and four patients hadvarusmalunion at neck. There were three cases of non-union and ten cases of delayed union of femoral shaft fracture. Femoral shaft fracture determined the total union period. Shaft complications were managed with or without secondary procedures as compared to femoral neck complications, which usually required more extensive procedures. It is concluded thatReconstruction nailing is a good treatment option in patients with undisplacedfracture of neck but it should not be preferred in displaced femoral neck fractures because of difficulties in reducing the fracture and its maintenance during nail insertion