Abstract
We tried to find the trauma mechanism and treatment rationale of ipsilateral concomitant
hip and distal femoral fractures involving the articular surface. Between 1988 and
1995, 15 cases of ipsilateral hip (confined to neck or trochanteric areas of the femur)
and distal (confined to supra- and intercondylar area of the femur) femoral articular
fractures were collected. The hip fractures consisted of 10 trochanteric fractures
and five neck fractures, which were managed with reduction and fixation in 14 (Knowles'
pin in eight, DHS in four and standard Gamma nail in two), and primary bipolar hemiarthroplastry
in one. The distal femoral articular fractures were open in 11; these were managed
with radical debridement, implantation of Septopal chains and immediate internal fixation,
followed by prophylactic autogenous bone grafting 6 weeks later in the recent six
cases (five Judet plates, four dynamic condylar screws and two condylar plates). The
other four closed distal femoral fractures were managed with early reduction and internal
fixation (two Judet plate, one dynamic condylar screw and one condylar plate). The
union time was 20.3 (12–48) weeks for proximal fractures and 23.7 (12–36) weeks for
distal fractures. Early infection developed in three cases. Nonunion of a femoral
neck fracture developed in one case. The other complications were implant failure
in one, coxa vara in one, refracture in one, delayed union in one and knee stiffness
in one.
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Article info
Publication history
Accepted:
September 28,
1999
Identification
Copyright
© 2000 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
