Management of Ipsilateral Fracture of Hip and Shaft of Femur

Background: Ipsilateral fractures of the hip with fracture of shaft of femur are rare injuries. They warrant special diagnostic and therapeutic considerations. Various techniques and implants have been developed to manage these fractures. No single device has been proved to be superior to others. Material and Methods: 8 patients (6 male and 2 female) with ipsilateral hip and shaft of femur fractures were treated with various fixation devices. Among the hip fractures there were 2 femoral neck and 6 peritrochanteric fractures. Functional outcome was assessed using the Friedman and Wyman classification. Results: All the 8 hip fractures united in a mean duration of 3 months. No osteonecrosis of the femoral head was noted. Of the femoral shaft fractures 5 united in a mean of 8.5 months, 3 were non-unions. One patient developed deep infection, which resolved with debridement and antibiotic treatment. Functional results were good in 4 patients, fair in 2 and poor in 2. Conclusion: Early diagnosis of all injuries and operative treatment are important to improve the functional outcome in ipsilateral hip and shaft fractures. Basically, each technique has individual advantages and disadvantages, and all are technically demanding. Most important factor determines the outcome is the anatomical reduction and stable internal fixation of both fractures.