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- Case Report Rare Experience of Bilateral Femoral Neck and Shaft Fractures - A Case Report -
- DaeHyun Choe, Jae-Ho Lee, Ki-Chul Park
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Journal of Musculoskeletal Trauma 2020;33(3):154-158.
DOI: https://doi.org/10.12671/jkfs.2020.33.3.154
Published online: July 31, 2020
Department of Orthopedic Surgery, Hanyang University Guri Hospital, Guri, Korea 
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Abstract
Ipsilateral fractures of the femoral neck and shaft are relatively common injuries and accompany 2% to 9% of all femoral shaft fractures. On the other hand, it is extremely rare for these injuries to occur bilaterally. This paper reports the authors’ experience of a case with bilateral femoral neck and shaft fractures. The patient sustained multiple injuries, including liver laceration with hemoperitoneum, bilateral open fractures of the tibia, and bilateral femoral neck, and shaft fractures caused by a high-speed motor vehicle accident. Under the circumstances, damage-control orthopedic principles were applied, and external fixators were initially placed. After the patient’s general condition showed improvement, both femurs were fixed with a reconstruction nail. Fracture healing was achieved without complications, such as avascular necrosis of the femoral head. Despite the rare occurrence, this paper describes this case because these injuries must be managed with meticulous attention.
J Korean Fract Soc. 2020 Jul;33(3):154-158. Korean.
Published online Jul 24, 2020.
https://doi.org/10.12671/jkfs.2020.33.3.154
Published online Jul 24, 2020.
https://doi.org/10.12671/jkfs.2020.33.3.154
Copyright © 2020 The Korean Fracture Society. All rights reserved.
Case Report
Rare Experience of Bilateral Femoral Neck and Shaft Fractures: A Case Report
Abstract
Ipsilateral fractures of the femoral neck and shaft are relatively common injuries and accompany 2% to 9% of all femoral shaft fractures. On the other hand, it is extremely rare for these injuries to occur bilaterally. This paper reports the authors' experience of a case with bilateral femoral neck and shaft fractures. The patient sustained multiple injuries, including liver laceration with hemoperitoneum, bilateral open fractures of the tibia, and bilateral femoral neck, and shaft fractures caused by a high-speed motor vehicle accident. Under the circumstances, damage-control orthopedic principles were applied, and external fixators were initially placed. After the patient's general condition showed improvement, both femurs were fixed with a reconstruction nail. Fracture healing was achieved without complications, such as avascular necrosis of the femoral head. Despite the rare occurrence, this paper describes this case because these injuries must be managed with meticulous attention.
Keywords
Femur, Femoral neck fracture, Femoral shaft fracture, Intramedullary nailing, Damage control surgery
Figures
Fig. 1
Initial both femur anterior-posterior radiographs. The undisplaced femoral neck fractures were barely identifiable on the initial evaluation.
Fig. 2
Both femur (A) and both tibia (B) anterior-posterior radiographs after external fixation. Damage control orthopedic principles were applied due to multiple trauma.
Fig. 3
Initial computed tomography images of both femoral neck fractures. Undisplaced fracture sites were identified later and are indicated as arrows.
Fig. 4
Anterior-posterior radiograph of both hip joints before definitive surgery. There was no progression of the displacement on both femoral neck fractures.
Fig. 5
Radiographs of both femur after intramedullary nailing. Femoral neck and shaft fractures are fixed with a recon-type intramedullary nail.
Fig. 6
Both femur (A, B) and standing whole lower extremity anterior-posterior (C) radiographs at 30 months after the internal fixation. Union was achieved without complications, such as avascular necrosis of the femoral head. At 18 months after surgery, fracture healing on both tibias was confirmed, and all plates were removed.
Notes
Financial support:None.
Conflict of interests:None.
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