| 摘要 |
lpsilateral femoral neck and shaft fractures are a rare but complex fracture
combination. Management of such double fractures is still a challenge
to most orthopaedists. From January 1983 to January 1993, 13 patients with
ipsilateral femoral neck and shaft fractures were treated here. One patient
was lost to follow-up. Treatment modalities could be divided into four
groups. It was found that shorter union time of neck fracture could be
achieved for patients undergoing broad dynamic compression plate (DCP)
fixation for shaft fractures and dynamic hip screw (DHS）。r multiple
screws for neck fracture. But shorter union time of shaft fracture was
noted for patients undergoing antegrade Kuntscher nailing or static interlocking
nailing and multiple screws for neck fractures. Retrograde nailing
with two Ender's pins was done in one patient, but aseptic necrosis of
femoral head was noted two years later, and total hip arthroplasty was performed.
Close reduction and skeletal traction were done in one patient for
her poor general condition. Complications occurred in sex cases. Functional outcome was good in nine, fair in one and poor in one patient. Results here suggest that plating of femoral shaft fractures with supplementary dynamic hip screw or multiple screw fixation of neck fracture may result in a higher union rate of neck fracture. Furthermore, this is a good alternative treatment method when compared with the high-technique, demanding antegrade Kuntscher nailing or interlocking nailing with supplementary multiple screw pinning. |
