Casey M J, Chapman M W
J Bone Joint Surg Am. 1979 Jun;61(4):503-9.
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.
我们从文献中回顾了52例同侧髋部和股骨干骨折的病例，并补充了我们自己的21例病例。文献报道的股骨颈骨折中有31%以及我们自己的1例在初次评估时被漏诊。骨不连和无菌性坏死的病例均来自先前报道的病例，发生在股骨颈骨折诊断和治疗延迟的患者中。我们的9例患者伴有同侧膝关节损伤。9例出现肺部并发症，均发生在骨牵引期间。如果患者在初始损伤后存活下来，预后出奇地好。我们得出结论，囊内髋部骨折应采用内固定治疗。骨干骨折通常能取得良好的长期效果。对于严重多发伤患者、高龄患者以及同侧膝关节损伤患者，应考虑对两处骨折均进行内固定。伊氏针很有用，我们的5例患者使用了伊氏针。
