Fracture of the ipsilateral neck of the femur in shaft nailing. The role of CT in diagnosis.
We report retrospective and prospective studies to identify the causes of fracture of the femoral neck associated with femoral shaft nailing on the same side. Of a total of 14 neck fractures in a series of 152 shaft nailings, eight were not visible on the initial pelvic radiographs. We used CT scans before and after operation, and fluoroscopy during the procedure in our prospective series, and reviewed abdominal CT scans retrospectively with the window set to bone level. Six of the eight undisplaced fractures were shown to have been present before operation, but two were iatrogenic. We recommend the preoperative use of CT scans of the femoral neck in high-risk patients such as those with associated fractures of the acetabulum, the distal femur or the patella. Early diagnosis will allow better general management and early fixation of the neck fracture.
Department of Orthopaedic Surgery, Yonsei University College of Medicine, Youngdong Severance Hospital, Seoul, Korea.
K H
KH
Yang
D Y
DY
Han
H W
HW
Park
H J
HJ
Kang
J H
JH
Park
D000063:Accidents, Traffic; D000077:Acetabulum / Q000293:injuries; D001858:Bone Nails; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D005471:Fluoroscopy; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D017102:Fracture Healing; D050723:Fractures, Bone / Q000209:etiology; D018460:Fractures, Comminuted / Q000601:surgery; D006801:Humans; D007049:Iatrogenic Disease; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D010329:Patella / Q000293:injuries; D011446:Prospective Studies; D011860:Radiography, Abdominal; D015641:Radiography, Interventional; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed