Objectives: To review the primary and the final results of surgical management of ipsilateral femoral neck and shaft fractures.
Subjects And Methods: Seventeen patients (2 female, 15 male, average age 37 years, range 20-60) with ipsilateral femoral neck and shaft fractures were treated by compression plate fixation for the femoral shaft fractures and dynamic hip screw or cannulated cancellous screw fixation for the neck fractures in Al-Razi and Al-Jahra Hospitals, Kuwait, from March 1996 to June 2002. The clinical and radiological primary and final results were analyzed retrospectively.
Results: The average follow-up for the primary outcomes was 3.6 years (range 2-6 years). 100% union of the femoral neck fractures, 0% osteonecrosis of the femoral head and 77% union of the shaft fractures were achieved. Complications of femoral shaft fractures, nonunion and metal failure, occurred in 4 (23%) patients and postsurgical infection occurred in 1 patient. At the final follow-up, 15 (88%) patients achieved good clinical outcome and 2 (12%) had fair outcome.
Conclusion: Our results show that compression plate fixation for the femoral shaft fracture and dynamic hip screw or cannulated screw fixation for the neck fracture in combination injury is a reliable and adequate technique.
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http://dx.doi.org/10.1159/000086929 | DOI Listing |
J Am Acad Orthop Surg
March 2025
From the Department of Orthopaedics, Denver Health Medical Center, University of Colorado School of Medicine, Denver, CO (Ward), and the Department of Orthopaedics, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA (Parry).
Introduction: Excessive lag screw sliding after cephalomedullary nail fixation of intertrochanteric fractures can be problematic. Set screws are typically inserted to engage the lag screw and backed off to allow for sliding. The purpose of this study was to determine whether statically locking set screws affected lag screw sliding or cutout.
View Article and Find Full Text PDFThis review focuses on the anatomic and radiographic characteristics of the pediatric proximal femur and the advantages and disadvantages of different protocols for the management of pediatric femoral neck fractures (PFNFs) in terms of fracture classification, reduction methods, reduction quality and fixation methods, with the goal of proposing an optimal treatment protocol for PFNFs to reduce the incidence of postoperative complications. The anatomic and radiographic characteristics of the pediatric proximal femur, including the presence of an active growth plate, an immature femoral calcar, greater trabecular density and plasticity and a relatively immature blood supply are very different from those of the adult proximal femur. Treatment protocols for PFNFs must differ from those for adult femoral neck fractures.
View Article and Find Full Text PDFEndokrynol Pol
March 2025
Department of Endocrine Disorders and Bone Metabolism, Chair of Endocrinology, Medical University of Lodz, Lodz, Poland.
Introduction: The authors of the latest recommendations state that osteoporosis diagnosis should not rely solely on densitometric (DXA) criteria. Fracture risk assessment is crucial for determining diagnosis and intervention thresholds. Comprehensive assessment of fracture risk requires consideration of bone mineral density (BMD) results, use of risk calculators like Fracture Risk Assessment Tool (FRAXTM), and analysis of clinical and lifestyle factors.
View Article and Find Full Text PDFEndokrynol Pol
March 2025
Department of Endocrine Disorders and Bone Metabolism, Chair of Endocrinology, Medical University of Lodz, Lodz, Poland.
Introduction: A densitometric diagnosis of osteoporosis qualifies patients to a diagnostic-therapeutic process, but densitometric evaluation may not be sufficient for osteopaenic patients. Therefore, it is essential to assess osteoporosis risk factors, fracture history, and 10-year fracture risk, and classify patients into low-, medium-, high-, or very high-risk categories. In our study, we aimed to assess the risk of fractures in patients with newly diagnosed osteopaenia and determine the percentage of patients at high and very high risk of fracture.
View Article and Find Full Text PDFHip Int
March 2025
Department of Orthopaedics unit 3, Christian Medical College, Vellore, India.
Background: Valgus osteotomy is a femoral head-preserving surgery to treat femoral neck non-union in young, active patients. The traditional approach, however, causes medialisation of the femoral shaft during valgus correction, which alters femoral anatomy and complicates conversion to total hip arthroplasty if head osteosynthesis fails. This study aims to outline a novel surgical technique, medial opening wedge valgus intertrochanteric osteotomy (VITO), and evaluate its clinical and radiographic outcomes, focusing on restoring hip biomechanics and improving union rates.
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