Ipsilateral fractures of femoral neck and shaft

Thirteen cases of ipsilateral intracapsular femoral neck and shaft fractures were seen. All cases occurred in young adults, with the mechanism of injury in all instances being high-energy trauma. The diagnosis of the femoral neck fracture was missed initially in four cases. The patients were divided into four groups according to treatment protocol: group 1 (two cases), both fractures treated nonoperatively; group 2 (four cases), femoral neck fracture treated nonoperatively, open reduction and internal fixation of femoral shaft fracture; group 3 (three cases), McMurray's osteotomy for femoral neck fracture and internal fixation for the femoral shaft fracture; and group 4 (four cases), open reduction and internal fixation of both fractures. The follow-up period ranged from 6 months to 10.1 years. There was a nonunion of one femoral neck fracture, while all shaft fractures united. The best results were seen in group 4 cases. It is also recommended that routine high-quality X-ray films of the hip should be done in all cases of femoral shaft fracture to decrease the high incidence of missed femoral neck fractures in ipsilateral injuries of the femur.