Ipsilateral hip and femoral shaft fractures treated with compression hip screw and long side-plate.

Complex femoral fractures involving the hip and shaft are not rare findings in the emergency room. The primary problem in the care of these patients is the preservation of their lives. The fracture combination under discussion is only a part of the injury complex sustained by these individuals. After the acute problems have been brought under control, care of the fractured femur and hip must be planned. Recently, most centers have favored giving priority to hip fractures, rigid fixation and early mobilization. However, for the fixation implants, variable fixation methods have been reported but are imperfect. In the past 5 years we have had some experience using compression hip screws with long side-plate to fix the different injured parts of these dual shaft and hip fractures at the same time. It seemed that application of these devices in dual hip and proximal shaft fractures, which are devoid of physiological bowing of the shaft, would get the best results. But when they are applied to dual fractures of the hip and the middle portion of the shaft, certain techniques, like adequate distal fixation, the prebending of the plate, primary bone graft and mobilization of the non-weight bearing pattern should be strictly adhered to for assurance of early callus formation and prevention of implant failure.