Lawson Eric, Madougou Soumaila, Chigblo Pascal, Quenum Gildas, Ouangré Abdourahmane, Tidjani Fiacre, Goukodadja Oswald, Hans-Moevi Akué Aristote
Department of Orthopaedic and Traumatology Surgery, Cotonou Teaching Hospital, Jericho Cotonou, Benin.
Department of Orthopaedic and Traumatology Surgery, Cotonou Teaching Hospital, Jericho Cotonou, Benin.
Chin J Traumatol. 2017 Jun;20(3):155-157. doi: 10.1016/j.cjtee.2016.07.002. Epub 2017 Apr 19.
To study the management and evaluate anatomical and functional outcomes of patients with ipsilateral proximal and shaft femoral fractures.
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 characteristics, therapeutic, anatomical and functional outcomes. The correlation between different parameters was analyzed with Fischer test. The significant threshold was defined for p value <0.05.
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 (B1 in 1 case and B2 in 1 case) and type C in 2 cases (C1 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).
Ipsilateral proximal and shaft femoral fractures are relatively uncommon in our daily activities. 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.
研究同侧股骨近端和股骨干骨折患者的治疗方法，并评估其解剖学和功能学结果。
一项回顾性、描述性和分析性研究，为期十年半，时间跨度从2005年1月1日至2015年6月30日。研究了以下参数：流行病学、骨折特征、治疗方法、解剖学和功能学结果。使用Fischer检验分析不同参数之间 的相关性。显著阈值定义为p值<0.05。
共记录了10份病历。男性7例，女性3例，性别比为2.33。平均年龄为4６岁（范围：29 - 62岁）。所有病例均为交通事故所致。摩托车与摩托车及摩托车与汽车碰撞最为常见。平均入院延迟时间为7小时（范围：1.5 - 24小时）。8例患者左侧受累最多。根据Garden分类，III型股骨颈骨折2例，II型1例，IV型1例。根据Ender分类，I型转子间骨折3例，VI型2例，VII型1例。根据AO分类，股骨干A型骨折6例（A2型4例，A3型2例），B型2例（B1型1例，B2型1例），C型2例（C1型1例，C2型1例）。平均手术延迟时间为28.7天（范围：11 - 61天）。对于股骨近端骨折，1例使用Moore假体，2例使用130°角钢板，4例使用长Gamma钉，2例使用双螺钉固定，1例使用动力髋螺钉。对于股骨干骨折，3例使用95°角钢板，2例使用低压缩钢板。4例使用长Gamma钉和1例使用130°长角钢板实现了骨愈合。2例股骨颈骨折出现骨不连。股骨近端骨折平均骨愈合延迟时间为5.14个月（范围：3 - 12个月），股骨干骨折为5个月（范围：3 - 8个月）。根据Friedman和Wyman标准，4例功能结果良好，4例中等，2例较差。关于植入物，骨愈合延迟在单植入物组和双植入物组之间无统计学差异（p = 0.52），在不同功能结果的患者之间也无统计学差异（p = 0.52）。功能结果在单植入物组和双植入物组之间无统计学差异（p = 0.46）。
同侧股骨近端和股骨干骨折在我们的日常活动中相对少见。未被注意到的股骨近端骨折难以识别。如果医生在治疗中同时考虑这两处骨折，结果通常较好。
