Ipsilateral concomitant fractures of the hip and femoral shaft.

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Abstract

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.

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