Ipsilateral fractures of the proximal femur and the femoral shaft
Authors:
P. Douša; J. Bartoníček; P. Havránek *
Authors place of work:
Ortopedickotramatologická klinika 3. LF UK a FNKV Praha
; Department of Paediatric Surgery and Traumatology of 3rd Faculty of Medicine, Charles University and FTNsP Prague
*; Klinika dětské chirurgie a traumatologie 3. LF UK a FTNsP Praha
Orthopaedic Department of 3rd Faculty of Medicine, Charles University, Prague
*
Published in the journal:
Úraz chir. 13., 2005, č.3
Summary
Ipsilateral fractures of the femur, i.e. fractures on the one side of the proximal femur and the femoral shaft, sometimes in combination with fracture of the distal femur, are severe injuries of the skeleton caused in the most cases by a highenergy insult. Until now, approximately 1000 of these very severe injuries have been reported in the literature. Reports on ipsilateral fractures of the femur in children however are rare. This type of injury occurs frequently along with associated injuries or polytraumas. Fractures of the femoral shaft often obscure fractures on the upper level and these must be carefully investigated. A clear radiograph of the femur, preferably in the long format with the hip and knee in both projections, if permitted by the condition of the patient, plays an irreplaceable role in the diagnosis. On the basis of their own experience and the literary data the authors have developed their own classification. They have divided the fractures into five groups and for each group they have specified optiones for treatment and types of implants to be used. They present a group of 44 patients operated on between 1994 and 2004. In 43 cases they used reconstruction nails for internal fixation. The long – term results were evaluated at the minimum interval of 1 year after surgery in 36 patients. 32 patients healed without complications. Severe complications were encountered in 4 cases. The evaluation also included the treatment of fractures in 6 children.
The aim of the article is to present an overview of the current treatment possibilities for ipsilateral fractures of the proximal femur and the femoral shaft.
Key words:
ipsilateral fractures of the proximal femur and the femoral shaft, reconstruction nails, ipsilateral fractures in children and adolescents.
Zdroje
1. Alho, A. Concurrent ipsilateral fractures of the hip and the shaft of the femur. A systematic review of 722 cases. Ann Chir Gynaecol. 86, 1997, 4, 326–336.
2. Alho, A. Concurrent ipsilateral fractures of the hip and femoral shaft. A Meta analysis of 659 cases. Acta Orthop Scand. 67, 1996, 1, 19–28.
3. Bartoníček, J., SkálaRosenbaum, J., Douša, P., Havránek, P. intertrochanterická osteotomie při řešení následků zlomenin proximálního femuru. Úraz chir. 12, 2004, 4, 1–10.
4. becher, h. Nagelung der Schenkelhalsfraktur bei gleichzeitig bestehender Oberschenkelfraktur. Zentralbl Chir. 23, 1951, 11, 1609–1612.
5. Bennet, F.S., Zinar, D.M., Kilgus, D.J. Ipsilateral hip and femoral shaft fractures. Clin Orthop. 296, 1993, 168–177.
6. Bernstein, S. M. Fractures of the femoral shaft and associated ipsilateral fractures of the hip. Orthop Clin N Amer. 5, 1974, 4, 799–818.
7. Bucholz, R.W., Brumback, R.J. Fractures of the shaft of the femur. In: Rockwood, C.A., Green, D.P., Bucholz, R.W. (eds.) Fractures in adults. Philadelphia: Lippincott, 1991, s. 1653–1724.
8. Daffner, R. H., Riemer, B. L., Butterfield, S. L. Ipsilateral femoral neck and shaft fractures: an overlooked association. Skeletal Radiol. 20, 1991, 4, 251–254.
9. delaney, w.m., street, d.m. Fracture of femoral shaft with fracture of neck of same femur. Treatment with intramedullary nail for shaft and Knowles pins for neck. J Int Coll Surg. 19, 1953, 3, 303.
10. Dencker, H. Femoral shaft fracture and fracture of the neck of the same femur. Acta Chir Scand. 129, 1965, 5, 597–605.
11. Douša, P., Bartoníček, J., Krbec, M. Ipsilaterální zlomeniny horního konce a diafýzy femuru. Acta Chir orthop Traum čech. 65, 1998, 5, 299–312.
12. Kang, S., McAndrew, M.P., Johnson, K.D. The reconstruction locked nail for complex fractures of the proximal femur. J Orthop Trauma. 9, 1995, 6, 453–463.
13. Käch, K. Kombinierte Frakturen des Schenkelhalses mit Femurschaftfrakturen. Helv chir Acta. 59, 1992, 56, 985–992.
14. lambiris, E., giannikas, d., galanopoulos, g. et al. A new classification and treatment protocol for combined fractures of the femoral Shift with the proximal or distal femur with closed locked intramedullary nailing: Clinical experience of 63 fractures. Orthopaedics. 26, 2003, 3, 305–309.
15. Látal, J., Šimko, P., Vajcziková, S. et al. Ipsilaterálne zlomeniny diafýzy a horného konca stehnovej kosti. Acta Chir ortop Traum čech. 61, 1994, 2, 328–333.
16. Müller, M.E., Nazarian, S., Koch, P. et al. The comprehensive classification of fractures of long bones. BerlinNew York: Springer 1990. 201 p.
17. Schatzker, J., Barrington, T. W. Fractures of the femoral neck associated with fractures of the same femoral shaft. Can J Surg. 11, 1968, 3, 297–305.
18. Schütz, M., Kolbeck, S., Südkamp, N. et al. The new AO femur nail for internal fixation of proximal femur. Předneseno na 20. světovém kongresu SICOT. Amsterdam, srpen 1996.
19. Stapert, J.W.J.L, Geesing, C.L.M., Jacobs, P.B.D. et al. First experience and complications with the long Gamma nail. J Trauma. 34, 1993, 3, 394–400.
20. Swiontkowski, M.F. Ipsilateral fractures of the femoral neck and shaft. J Bone Joint Surg. 66A, 1984, 2, 260–268.
21. Šimko, P., Buchinger, W. Indikácie a použitie štandardného a dlhého gammaklinca. Acta Chir orthop Traum čech. 62, 1995, 5, 289–296.
22. Türk, C. Y., Sakin, V., Balkar, F. et al. The treatment of complex fractures in the proximal femur with Long Gamma nail: A Prospective Study. Předneseno na 20. světovém kongresu SICOT. Amsterdam, srpen 1996.
23. Winquist, R. A., Hansen, S.T. Closed intramedullary nailing of femoral fractures. A report of live hundred and twenty cases. J Bone Joint Surg. 66A, 1984, 4, 529–539.
24. Wiss, D.A., Sima, W., Brien, W.W. Ipsilateral fractures of the femoral neck and shaft. J Orthop Trauma. 6, 1992, 2, 159–166.
25. Wruhs, O., Jenny, J.Y., Karger, C. Versorgung von Kombinationsverletzungen von Femurschaft und Schenkelhalsfrakturen mit Verriegelungnagel. Unfallchirurg. 12, 1986, 4, 208–214.
26. Wu, C.C., Shih, C.H. Ipsilateral femoral neck and shaft fractures. Acta Orthop Scand. 62, 1991, 4, 346–351.
Štítky
Surgery Traumatology Trauma surgeryČlánok vyšiel v časopise
Trauma Surgery
2005 Číslo 3
- Spasmolytic Effect of Metamizole
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole in perioperative treatment in children under 14 years – results of a questionnaire survey from practice
- Current Insights into the Antispasmodic and Analgesic Effects of Metamizole on the Gastrointestinal Tract
- Obstacle Called Vasospasm: Which Solution Is Most Effective in Microsurgery and How to Pharmacologically Assist It?
Najčítanejšie v tomto čísle
- Rupture of the diaphragm – diagnostic pitfalls and methods of treatment
- Ipsilateral fractures of the proximal femur and the femoral shaft