Ipsilateral fractures of the femoral neck and shaft

Ipsilateral femoral shaft and neck fractures are difficult to treat. From 1 989 to 1998, we treated 18 patients with these complex fractures. There wer e 14 male and 4 female with an average age of 40 years. Most resulted from high-energy trauma. The average follow-up period is 41 months. All but one of the fractures united well. The mean time to union is 5.2 +/- 2.3 months in the diaphysis and 4.16+/-2 months in the neck. No cases of the femoral n eck fracture or osteonecrosis of the femoral head were observed during the follow-up period. Fourteen cases were treated with a standard protocol of p lates for diaphyseal fractures and lag screws or dynamic hip screws (DHS) f ixations for the femoral neck fractures. There were 13 good and 1 fair func tional results. Two neglected neck fractures were treated with interlocking nailing for diaphyseal fracture with fair results. We conclude that a plat e on the shaft and sliding hip screws or separate screws in the hip is a re liable method for ipsilateral femoral neck and shaft Fractures. (C) 2000 El sevier Science Ltd. All rights reserved.