Surgical treatment for ipsilateral fractures of the hip and femoral shaft.

Concomitant ipsilateral femoral shaft and neck fractures are difficult to treat. There is still no consensus on the optimal treatment of these complex fractures. Forty-seven patients with these complex fractures were treated in Kaohsiung Medical University Hospital between the periods of 1982 and 1998. Our standard treatment protocol is plate fixation for femoral shaft fracture and lag screw or dynamic hip screw (DHS) fixation for hip fracture. Among 42 cases treated with this protocol, 34 were males and 8 were females with an average age of 36 years and average follow-up period of 55 months. We divided hip fractures into two groups: femoral neck fracture as group I and intertrochanteric fracture as group II. There were no non-union and osteonecrosis of the hip in either group. One diaphyseal non-union was observed in group I and four in group II. There were 92 and 76% good functional results in groups I and II, respectively. The result shows that our standard method can yield a reliable outcome in group I, but not in group II.