Ipsilateral proximal and shaft femoral fractures

Eric Lawson; Sournaila Madougou; Pascal Chigblo; Gildas Quenum; Abdourahrnane Ouangré; Fiacre Tidjani; Oswald Goukodadja; Aristote Hans-Moevi Akué

摘要

Purpose:To study the management and evaluate anatomical and functional outcomes of patients with ipsilateral proximal and shaft femoral fractures.Methods:A retrospective,descriptive and analytic study lasted for ten years and a half ranging from January 1,2005 to June 30,2015.The following parameters were studied:epidemiology,fracture characteristics,therapeutic,anatomical and functional outcomes.The correlation between different parameters was analyzed with Fischer test.The significant threshold was defined for p value ＜0.05.Results:Ten medical files were registered.There were 7 men and 3 women,with a sex ratio of 2.33.The average age was 46 years (range:29-62 years).It was about traffic road accidents in all cases.Motorcycle -motorcycle and motorcycle-car collision were most frequent.Average admission delay was 7 h (range:1.5-24 h).Left side was most reached in 8 cases.According to Garden classification,there was type Ⅲ cervical fracture in 2 cases,type Ⅱ in 1 case and type Ⅳ in 1 case.According to Ender classification,there was type Ⅰ trochanteric fracture in 3 cases,type Ⅵ in 2 cases and type Ⅶ in 1 case.According to AO classification,there was type A shaft fracture in 6 cases (A2 in 4 cases and A3 in 2 cases),type B in 2 cases (B1 in 1 case and B2 in 1 case) and type C in 2 cases (C1 in 1 case and C2 in 1 case).Average surgical delay was 28.7 days (range:11-61 days).For proximal femoral fracture,Moore prosthesis was used in 1 case,blade plate 130° in 2 cases,long Gamma nail in 4 cases,double screwing in 2 cases and dynamic hip screw in 1 case.For shaft femoral fracture,blade plate 95° was used in 3 cases,low compressive plate in 2 cases.Osseous contention was achieved in 4 cases with long Gamma nail and in 1 case with long blade plate 130°.Nonunion of cervical fracture was achieved in 2 cases.The average osseous healing delay was 5.14 months (range:3-12 months) for proximal femoral fracture and 5 months (range:3-8 months) for shaft femoral fractures.According to Friedman and Wyman criteria,functional results were good in 4 cases,average in 4 cases and bad in 2 cases.Regarding implants,healing delay showed no statistic difference between one-implant group and two-implant group (p =0.52),and among the patients with different functional outcomes (p =0.52).Functional outcomes showed no statistic difference between one-implant group and two-implant group (p =0.46).Conclusion:Ipsilateral proximal and shaft femoral fractures are relatively uncommon in our daily activities.It is difficult to recognize proximal femoral fractures which are unnoticed.Results are generally good if the doctors take the two fractures into account in the management.

机译：目的：研究同侧股骨近端和干部骨折的治疗方法，评估其解剖和功能结局。方法：回顾性，描述性和分析性研究从2005年1月1日至2015年6月30日进行，历时十年半。对以下参数进行了研究：流行病学，骨折特征，治疗，解剖学和功能预后。通过Fischer检验分析了不同参数之间的相关性，定义了显着阈值，p值＜0.05。结果：登记了10个医学档案。男性7例，女性3例，性别比为2.33。平均年龄为46岁（范围：29-62岁）。所有情况下都是交通事故。摩托车，摩托车和摩托车相撞的发生率最高。平均入院延迟为7 h（范围：1.5-24 h）。左侧最多者8例。根据Garden分类，Ⅲ型宫颈骨折2例，Ⅱ型1例，Ⅳ型1ca。 se。根据Ender分类，有Ⅰ型转子粗隆骨折3例，Ⅵ型有2例，Ⅶ型1例。根据AO分类，有A型股骨干骨折6例（A2骨折4例，A3骨折） 2例），B型2例（B1 1例，B2 1例）和C型2例（C1 1例，C2 1例）。平均手术延迟为28.7天（范围：11- 61天）。对于股骨近端骨折，使用摩尔假体1例，刀片130°固定2例，长伽马钉4例，双螺钉2例，动力髋螺钉1例。对于股骨干骨折，刀片板95°3例，低压力板2例。长伽马钉4例发生骨质内角化，长刀片130°发生1例骨质疏松.2例发生颈椎骨折不愈合。股骨近端骨折的平均骨愈合延迟为5.14个月（范围：3-12个月），股骨干骨折的平均骨愈合延迟为5个月（范围：3-8个月）。 o按照弗里德曼和怀曼准则，功能性结果好4例，平均4例，差2例。就种植体而言，一种植体组和两种植体组的愈合延迟无统计学差异（p = 0.52），并且功能预后不同的患者之间（p = 0.52）。一种植体组和二种植体组之间的功能结果无统计学差异（p = 0.46）。结论：同侧近端和股骨干骨折在我们的日常活动中相对少见难以识别未注意到的股骨近端骨折。如果医生在管理中考虑这两个骨折，通常效果良好。

Ipsilateral proximal and shaft femoral fractures

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