| Abstrakt: |
Multifocal fractures of the femur in modern traumatology are becoming more frequent and often pose difficult problems for treatment. These fractures are frequently associated with other comorbidities, necessitating thorough trauma life support assessment and interdisciplinary care. Associated ipsilateral femoral neck fractures have been reported to occur in 1% to 9% of femoral shaft fractures. The associated femoral neck fracture is often nondisplaced, and diagnosis is delayed or missed in up to one-third of cases. It is essential to carefully evaluate the femoral neck in all patients sustaining high-energy femoral shaft fractures. No consensus exists regarding the timing of surgery, sequence of fixation, or the optimal implant choice in the treatment of ipsilateral femoral neck and shaft fractures because these fractures are relatively rare, and patients often present with concomitant multi-system injuries. Fixation of these combined injury patterns is challenging, and multiple treatment options exist. Treatment goals should include anatomic reduction and adequate fixation of the femoral neck fracture, as well as restoration of the length, alignment, and rotation of the femoral shaft fracture. While most authors recommend surgical fixation within 24 hours, if possible, and to give priority to anatomic reduction and optimal stabilization of the femoral neck fracture because nonunion, malunion, or avascular necrosis of this injury is more difficult to successfully treat, other studies demonstrate that the use of separate implants can lead to a better result. [ABSTRACT FROM AUTHOR] |
