Frequency of Ipsilateral Neck and Shaft of Femur Fracture at Tertiary Care Hospital

Authors

  • Sajid Akhtar Saidu Medical College/Saidu Group of Teaching Hospital, Swat, Pakistan
  • Muzammil Ahmad Shah Saidu Medical College, Saidu Sharif, Swat KP Pakistan
  • Asghar Khan Saidu Group of Teaching Hospital, Swat, Pakistan.
  • Fazl-e-Subhan Saidu Group of Teaching Hospital, Swat, Pakistan.
  • Naeemuallah Saidu Group of Teaching Hospital, Swat, Pakistan.

DOI:

https://doi.org/10.52206/jsmc.2024.14.3.894

Abstract

Background: The ipsilateral femoral neck and shaft had a high rate of miss-diagnosing. The incidence of femoral neck and shaft fracture in adult is 10 times higher than the children and adolescent. Femoral neck fracture is a public health problem; the incidence of femoral neck fracture is increasing due to increase in road traffic accident. These fractures are often caused by high-energy trauma such as roadside accidents, falls from height, and sports injuries.
Objectives: The study aims to find out the incidence of ipsilateral femoral neck in femur shaft fracture in a tertiary care hospital.
Materials and Methods: This is a cross-sectional study conducted at Department of Orthopedic and Trauma Center Saidu Group of Teaching Hospital Swat-The study included 227 patients presented to trauma and emergency unit at Saidu group of teaching Hospital Swat (SGTH) with shaft of femur fracture between January 15, 2023 to January 14, 2024 (One-year duration).
Results: Out of the 227 subjects with a shaft of femur fracture, 160 presented with this fracture due to road traffic accidents, 51 after a history of falls, and 16 subjects due to other trauma. Among the total patients, 28 (12.30%) had an additional ipsilateral neck of femur (NOF) fracture, including 19 males and 9 females. Out of these 28 patients, 21 were associated with road traffic accidents, 5 with a history of falls, and the remaining 2 with other traumas. The occurrence of concurrent shaft of femur and NOF fractures was most common in the age group of 10-30 years.
Conclusion: With around 12.30% of cases showing this dual injury, using advanced imaging like CT scans or MRI alongside thorough clinical assessment is crucial to avoid missed diagnoses and complications. By doing so, clinicians can improve diagnostic accuracy, ensure timely treatment, and enhance patient care.
Keywords: Fracture, Femur bone, History of Fall, Incidence, Neck of femur, Road Traffic Accident, Shaft of femur, Trauma.

References

Iyidobi EC. Epidemiological Pattern of Closed Femoral Shaft Fractures in a Regional TertiaryHospital in Enugu, Nigeria. J Biosci Med. 2019;7(5):180-8. DOI: https://doi.org/10.4236/jbm.2019.75019

Park YC, Um KS, Hong SP, Oh CW, Kim S, Yang KH. Preoperative "Computed tomography capsular sign" for the detection of occult ipsilateral femoral neck fractures associated with femoral shaft fractures. Injury. 2020;51(4):1051-1056. DOI: https://doi.org/10.1016/j.injury.2020.02.067

Vidyadhara S, Rao SK. Cephalomedullary nails in the management of ipsilateral neck and shaft fractures of the femur--one or two femoral neck screws? Injury. 2009;40(3):296-303. DOI: https://doi.org/10.1016/j.injury.2008.08.009

Boulton CL, Pollak AN. Special topic: Ipsilateral femoral neck and shaft fractures--does evidence give us the answer? Injury. 2015;46(3):478-83. DOI: https://doi.org/10.1016/j.injury.2014.11.021

Lundin N, Huttunen TT, Enocson A, Marcano AI, Felländer-Tsai L, Berg HE. Epidemiology and mortality of pelvic and femur fractures A nationwide register study of 417,840 fractures in Sweden across 16 years: Diverging trends for potentially lethal fractures. Acta Orthop. 2021; 92:323-328. DOI: https://doi.org/10.1080/17453674.2021.1878329

Pradhan P, Townsend TK, Cook D, Feldman L, Canizares MF, Watkins C, et al. Do all pediatric femoral shaft fractures need a computed tomography scan of the ipsilateral femoral neck? Calculating the incidence of concomitant femoral neck and shaft fractures. J Pediatr Orthop. 2023;43 (3):e204-8. DOI: https://doi.org/10.1097/BPO.0000000000002334

Duckworth AD, Bennet SJ, Aderinto J, Keating JF. Fixation of intracapsular fractures of the femoral neck in young patients: risk factors for failure. J Bone Joint Surg Br. 2011;93(6):811816. DOI: https://doi.org/10.1302/0301-620X.93B6.26432

Dogrul BN, Kiliccalan I, Asci ES, Peker SC. Blunt trauma related chest wall and pulmonary injuries: An overview. Chin J Traumatol. 2020; 23:125-138. DOI: https://mednexus.org/doi/abs/10.1016/j.cjtee.2020.04.003

Tornetta P, Kain MS, Creevy WR. Diagnosis of femoral neck fractures in patients with a femoral shaft fracture. Improvement with a standard protocol. J Bone Joint Surg Am. 2007;89(1):39-43. DOI: https://doi.org/10.2106/JBJS.F.00297

Marins MH, Pallone LV, de Souza Vaz BA, Ferreira AM, Nogueira-Barbosa MH, Salim R, et al. Ipsilateral femoral neck and shaft fractures. When do we need further image screening of the hip? Injury. 2021;52(Suppl): S65-9. DOI: https://doi.org/10.1016/j.injury.2021.01.040

Palm H. Hip fracture: the choice of surgery. Orthogeriatrics: The Management of Older Patients with Fragility Fractures. 2021:125-41. DOI: https://doi.org/10.1007/978-3-030-48126-1_9

Oh CW, Kim JW, Park KC, Apivatthakakul T, Luo CF, Wong MK, et al. Clinical outcomes and affecting factors of ipsilateral femoral neck and shaft fractures - Multination, multicenter analysis. J Orthop Sci. 2023;28(3):614-620. DOI: https://doi.org/10. 1016/j.jos.2021.12.021

Chen CH, Chen TB, Cheng YM, Chang JK, Lin SY, Hung SH. Ipsilateral fractures of the femoral neck and shaft. Injury. 2000;31(9):719-22. DOI: https://doi.org/10.1016/s0020-1383(00)00096-6

O'Toole RV. Diagnosis of femoral neck fracture associated with femoral shaft fracture: blinded comparison of computed tomography and plain radiography. J Orthop Trauma. 2013;27(6):325330. DOI: https://doi.org/10.1097/BOT.0b013e318271b6c8

Boulton CL, Pollak AN. Special topic: Ipsilateral femoral neck and shaft fractures--does evidence give us the answer? Injury. 2015;46(3):478-83. DOI: https://doi.org/10.1016/j.injury.2014.11.021

Ram GG, Kumar CA. Functional and radiological outcome of ipsilateral neck with shaft of femur fracture. Int J Orthop Traumatol Surg Sci. 202015;6(1):22-25. DOI: https://www.jojs.in/doi/pdf/10.5005/jp-journals-10079-1012

Aggarwal M, Kishore K, Arora C, Pandey S, Kumar V. Ipsilateral femoral neck and shaft femur fracture in a child: nonoperative management. J Clin Diagn Res. 2019;13(9). DOI: https://doi.org/10.7860/JCDR/2019/42177.13158

Almigdad AK, Alazaydeh SA, Mustafa MS, Mu'men IA, Alfukaha HA. A review of proximal femur fracture patterns, etiologies and sociodemographic features. International Journal of Orthopaedics. 2022;8(3):115-8. DOI: https://doi.org/10.22271/ortho.2022.v8.i3b.3189

Hak DJ, Mauffrey C, Hake M, Hammerberg EM, Stahel PF. Ipsilateral Femoral Neck and Shaft Fractures: Current Diagnostic and Treatment Strategies. Orthopedics. 2015;38(4):247-251. DOI: https://dx.doi.org/10.3928/01477447-20150402-05

Ashraf M, Ashraf N. Underage motorbike driving in Pakistan: a neurosurgical burden heading towards societal disaster. Surgical neurology international. 2022;13. DOI: https://doi.org/10.25259/SNI_1261_2021

Lawson E, Madougou S, Chigblo P, Quenum G, Ouangré A, Tidjani F, et al. Ipsilateral proximal and shaft femoral fractures. Chin J Traumatol. 2017;20(03):155-7. DOI: https://mednexus.org/doi/abs/10.1016/j.cjtee.2016.07.002

Khan B, Tareen NU, Junaid M. Frequency of ipsilateral femoral neck fractures in patients with femoral shaft fractures. Biological and Clinical Sciences Research Journal. 2023 11;2023(1):457. DOI: https://doi.org/10.54112/bcsrj.v2023i1.457

Green DP. Rockwood and Green's fractures in adults. Lippincott Williams & Wilkins; 2010.

Additional Files

Published

24-07-2024

How to Cite

1.
Sajid Akhtar, Muzammil Ahmad Shah, Asghar Khan, Fazl-e-Subhan, Naeemuallah. Frequency of Ipsilateral Neck and Shaft of Femur Fracture at Tertiary Care Hospital . J Saidu Med Coll Swat [Internet]. 2024 Jul. 24 [cited 2024 Dec. 5];14(3):139-43. Available from: https://jsmc.pk/index.php/jsmc/article/view/894