Femoral shaft fractures complicated by fracture-dislocations of the ipsilateral hip.

A series of 16 consecutive adults with femoral shaft fractures complicated by fracture-dislocations of the ipsilateral hip joint was prospectively studied. There were 11 posterior dislocations and five central dislocations. The treatment consisted of early closed reduction of the dislocation with the assistance of an external fixator, delayed reamed intramedullary nailing of the femoral fracture, and conservative or surgical treatment of the hip joint according to the indications. The follow-up period was 2-8 years (median, 3.5 years). Although an 18.8% (3 of 16) complication rate was noted, the outcome was satisfactory for all 16 hip joints. When such complicated combined injuries are sustained, the technique described here is the most reasonable treatment.