Ipsilateral proximal and shaft femoral fractures
Purpose： To study the management and evaluate anatomical and functional outcomes of patients with ipsilateral proximal and shaft femoral fractures. Methods： A retrospective, descriptive and analytic study lasted for ten years and a half ranging from January 1, 2005 to June 30, 2015. The following pa...
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| Published in: | Chinese journal of traumatology Vol. 20; no. 3; pp. 155 - 157 |
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| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
China
Elsevier B.V
01-06-2017
Department of Orthopaedic and Traumatology Surgery, Cotonou Teaching Hospital, Jericho Cotonou, Benin Elsevier |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Purpose： To study the management and evaluate anatomical and functional outcomes of patients with ipsilateral proximal and shaft femoral fractures. Methods： A retrospective, descriptive and analytic study lasted for ten years and a half ranging from January 1, 2005 to June 30, 2015. The following parameters were studied： epidemiology, fracture char- acteristics, therapeutic, anatomical and functional outcomes. The correlation between different param- eters was analyzed with Fischer test. The significant threshold was defined for p value 〈0.05. Results： Ten medical files were registered. There were 7 men and 3 women, with a sex ratio of 2.33. The average age was 46 years （range： 29-62 years）. It was about traffic road accidents in all cases. Motorcycle -motorcycle and motorcycle-car collision were most frequent. Average admission delay was 7 h （range： 1.5-24 h）. Left side was most reached in 8 cases. According to Garden classification, there was type Ⅲ cervical fracture in 2 cases, type Ⅱ in 1 case and type Ⅳ in 1 case. According to Ender classification, there was type I trochanteric fracture in 3 cases, type Ⅵ in 2 cases and type Ⅶ in 1 case. According to AO classification, there was type A shaft fracture in 6 cases （A2 in 4 cases and A3 in 2 cases）, type B in 2 cases （BI in 1 case and B2 in 1 case） and type C in 2 cases （CI in 1 case and C2 in 1 case）. Average surgical delay was 28.7 days （range： 11-61 days）. For proximal femoral fracture, Moore prosthesis was used in 1 case, blade plate 130° in 2 cases, long Gamma nail in 4 cases, double screwing in 2 cases and dynamic hip screw in 1 case. For shaft femoral fracture, blade plate 95° was used in 3 cases, low compressive plate in 2 cases. Osseous contention was achieved in 4 cases with long Gamma nail and in 1 case with long blade plate 130°. Nonunion of cervical fracture was achieved in 2 cases. The average osseous healing delay was 5.14 months （range： 3-12 months） for proximal femoral fracture and 5 months （range： 3-8 months） for shaft femoral fractures. According to Friedman and Wyman criteria, functional results were good in 4 cases, average in 4 cases and bad in 2 cases. Regarding implants, healing delay showed no statistic difference between one-implant group and two-implant group （p = 0.52）, and among the patients with different functional outcomes （p = 0.52）. Functional outcomes showed no statistic difference between one-implant group and two-implant group （p = 0.46）. Conclusion： Ipsilateral proximal and shaft femoral fractures are relatively uncommon in our daily ac- tivities. It is difficult to recognize proximal femoral fractures which are unnoticed. Results are generally good if the doctors take the two fractures into account in the management. |
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| Bibliography: | Purpose： To study the management and evaluate anatomical and functional outcomes of patients with ipsilateral proximal and shaft femoral fractures. Methods： A retrospective, descriptive and analytic study lasted for ten years and a half ranging from January 1, 2005 to June 30, 2015. The following parameters were studied： epidemiology, fracture char- acteristics, therapeutic, anatomical and functional outcomes. The correlation between different param- eters was analyzed with Fischer test. The significant threshold was defined for p value 〈0.05. Results： Ten medical files were registered. There were 7 men and 3 women, with a sex ratio of 2.33. The average age was 46 years （range： 29-62 years）. It was about traffic road accidents in all cases. Motorcycle -motorcycle and motorcycle-car collision were most frequent. Average admission delay was 7 h （range： 1.5-24 h）. Left side was most reached in 8 cases. According to Garden classification, there was type Ⅲ cervical fracture in 2 cases, type Ⅱ in 1 case and type Ⅳ in 1 case. According to Ender classification, there was type I trochanteric fracture in 3 cases, type Ⅵ in 2 cases and type Ⅶ in 1 case. According to AO classification, there was type A shaft fracture in 6 cases （A2 in 4 cases and A3 in 2 cases）, type B in 2 cases （BI in 1 case and B2 in 1 case） and type C in 2 cases （CI in 1 case and C2 in 1 case）. Average surgical delay was 28.7 days （range： 11-61 days）. For proximal femoral fracture, Moore prosthesis was used in 1 case, blade plate 130° in 2 cases, long Gamma nail in 4 cases, double screwing in 2 cases and dynamic hip screw in 1 case. For shaft femoral fracture, blade plate 95° was used in 3 cases, low compressive plate in 2 cases. Osseous contention was achieved in 4 cases with long Gamma nail and in 1 case with long blade plate 130°. Nonunion of cervical fracture was achieved in 2 cases. The average osseous healing delay was 5.14 months （range： 3-12 months） for proximal femoral fracture and 5 months （range： 3-8 months） for shaft femoral fractures. According to Friedman and Wyman criteria, functional results were good in 4 cases, average in 4 cases and bad in 2 cases. Regarding implants, healing delay showed no statistic difference between one-implant group and two-implant group （p = 0.52）, and among the patients with different functional outcomes （p = 0.52）. Functional outcomes showed no statistic difference between one-implant group and two-implant group （p = 0.46）. Conclusion： Ipsilateral proximal and shaft femoral fractures are relatively uncommon in our daily ac- tivities. It is difficult to recognize proximal femoral fractures which are unnoticed. Results are generally good if the doctors take the two fractures into account in the management. Femoral fractures;Proximal fractures;Shaft fractures 50-1115/R ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 1008-1275 |
| DOI: | 10.1016/j.cjtee.2016.07.002 |