Cùng bên cổ xương đùi và gãy trục là chấn thương phổ biến đó là một thách thức phẫu thuật. Bệnh nhân tương đối trẻ tuổi, đang highenergy Thông thường nạn nhân của chấn thương và chấn thương thường gặp có đa hệ bền vững. Một midshaft nghiền xương đùi bị gãy xương thứ cấp để tải hướng trục | Ipsilateral Femoral Neck and Shaft Fractures Allan E. Peljovich MD MPH and Brendan M. Patterson MD Abstract Ipsilateral femoral neck and shaft fractures are uncommon injuries that present a surgical challenge. Patients are relatively young are usually victims of high-energy trauma and have frequently sustained multisystem injuries. A comminuted midshaft femoral fracture secondary to axial loading should alert the treating physician to the possibility of an associated femoral neck fracture. This is important in light of the frequency of unrecognized ipsilateral femoral neck fractures. Several treatment options are described in the literature but no clear consensus exists regarding the optimal treatment of these complex fractures. The authors contend that given the potentially devastating complications of the femoral neck fracture in young patients . avascular necrosis nonunion and malunion the neck fracture should be treated first and the shaft fracture second. The authors present an algorithm for the diagnosis and management of this injury based on a review of the literature an understanding of the biology and severity of this injury and the technical aspects of surgical treatment. J Am Acad Orthop Surg 1998 6 106-113 Fractures of the femoral neck and fractures of the femoral shaft are both common. However the combination of ipsilateral femoral neck and shaft fractures is an uncommon injury pattern occurring in 2 to 6 of all femoral shaft 2 Wiss et al3 encountered 33 such injuries over a 3-year period Swiontkowski et al4 treated 15 cases over a 10-year period and Bose et al5 treated 5 cases over a 2year period. Ipsilateral femoral neck and shaft fractures present a challenging problem for the treating surgeon. The ideal treatment of each injury often necessitates a less than ideal treatment for the associated fracture. Complications of the injury and its management include avascular necrosis AVN of the femoral head nonunion malunion and fat embolism.
