[Femoral shaft fracture and secondary diagnosis of ipsilateral femoral neck fracture. Typical constellation or a complication of the distal femoral nail (DFN)?].

We present a case of two patients with a distal femur shaft fracture due to a high velocity trauma. Both were treated with a distal femur nail (DFN). After mobilisation a fracture of the neck of the femur was diagnosed which was not seen in the x-rays on admission. In this paper we discuss whether this is a typical constellation of ipsilateral fractures of the neck of the femur in femur shaft fractures or a complication of implantation of a DFN. Immediately after operative treatment of a femur shaft fracture specifically after high velocity trauma or in polytraumatized patients an x-ray of the hip in two plains should be made in the same narcosis. A possible fracture of the neck of the femur could be treated at same time. Post-operatively a further diagnostic should be done in case of suspicion, e.g. pain during mobilisation.