FRACTURE OF THE IPSILATERAL NECK OF THE FEMUR IN SHAFT NAILING - THE ROLE OF CT IN DIAGNOSIS

We report retrospective and prospective studies to identify the causes of fracture of the femoral neck associated with femoral shaft nailing on the same side. Of a total of 14 neck fractures in a series of 152 shaft nailings, eight were not visible on the initial pelvic radiograp hs. We used CT scans before and after operation, and fluoroscopy durin g the procedure in our prospective series, and reviewed abdominal CT s cans retrospectively with the window set to bone level. Six of the eig ht undisplaced fractures were shown to have been present before operat ion, but two were iatrogenic. We recommend the preoperative use of CT scans of the femoral neck in high-risk patients such as those with ass ociated fractures of the acetabulum, the distal femur or the patella, Early diagnosis will allow better general management and early fixatio n of the neck fracture.