Wang Hai-qiang, Han Yi-sheng, Li Xin-kui, Li Ming-quan, Wei Yi-yong, Wu Zi-xiang
Institute of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
Chin J Traumatol. 2008 Jun;11(3):171-4. doi: 10.1016/s1008-1275(08)60036-x.
To investigate the clinical characteristics, treatment options and causes of misdiagnosis of ipsilateral femoral neck and shaft fractures.
Among 20 patients with ipsilateral femoral neck and shaft fractures, 19 were treated operatively and 1 was treated conservatively. Sixteen cases of femoral shaft fractures were treated by open reduction and internal fixation with compressive plate, and 2 cases were treated with interlocking intramedullary nailing. Eighteen femoral neck fractures were treated with cannulated screws. Another patient was treated with proximal femoral nail to fix both the neck and shaft. Delayed diagnosis for femoral neck fractures occurred in 2 cases preoperatively.
A total of 19 patients were followed up. The follow up period ranged from 5 to 48 months with an average of 15 months. All the fractures were healed.
For case of femoral shaft fracture caused by high energy injury, an AP pelvic film should be routinely taken. Once the femoral neck fracture is recognized, operative reduction and fixation should be performed in time. Femoral neck and shaft fractures should be fixed separately.
探讨同侧股骨颈与股骨干骨折的临床特点、治疗方法及误诊原因。
20例同侧股骨颈与股骨干骨折患者中，19例接受手术治疗，1例接受保守治疗。16例股骨干骨折采用切开复位加压钢板内固定治疗，2例采用带锁髓内钉治疗。18例股骨颈骨折采用空心螺钉治疗。另1例患者采用股骨近端髓内钉固定股骨颈和股骨干。术前有2例股骨颈骨折诊断延迟。
共19例患者获得随访。随访时间5～48个月，平均15个月。所有骨折均愈合。
对于高能损伤所致股骨干骨折，应常规拍摄骨盆正位片。一旦确诊股骨颈骨折，应及时行手术复位固定。股骨颈骨折与股骨干骨折应分别固定。
