Li Shou-min, Zhu Chen, Kong Rong, Xia Rui, Fang Shi-yuan, Zhang Guang-ping
Department of Orthopedics, Affiliated Provincial Hospital of Anhui Medical University, Hefei Anhui 230001, China.
Zhonghua Yi Xue Za Zhi. 2010 Feb 23;90(7):486-8.
To analyze the misdiagnoses of femoral shaft fracture combined with ipsilateral femoral neck or femoral fractures.
Over the past six years, eight misdiagnosed cases of ipsilateral femoral neck or femoral fractures missed patients, aged 25 to 59 years old (mean: 41.7), were treated at our department. An initial diagnosis of femoral shaft fracture was later revised as ipsilateral femoral shaft with supra-condylar fracture of femoral neck or femur. Femoral shaft fracture was fixed with armor plate, 3-screw hollow compression fixation of femoral neck; two cases of femoral condylar fractures of distal femoral condyle with anatomical plate fixation and 1 case of intraoperative change into the retrograde femoral intramedullary nail fixation.
The mean post-operative follow-up was 3.5 years. All fractures healed with excellent hip and knee functions.
For those with a strong reverse and torsional violence, femoral shaft fracture combined with ipsilateral femoral neck or femoral fractures may be easily misdiagnosed. A preoperative conventional hip-knee X-ray film is an effective way to avoid a misdiagnosis.