Dynamic hip screw and compression plate fixation of ipsilateral femoral neck and shaft fractures

Abalo A, Dossim A, Ouro Bangna AF, Tomta K, Assiobo A, Walla A
Department of Orthopaedics, Tokoin Medical University Hospital, Lome, Togo

PURPOSE. To evaluate surgical outcomes of ipsilateral femoral neck and shaft fractures.

METHODS. Between April 1997 and September 2004, 29 men and 8 women (mean age, 37 years) underwent fixation of femoral neck and shaft fractures using a dynamic compression plate plus a dynamic hip screw or screws. There were 30 femoral neck and 7 pertrochanteric fractures. Functional results were assessed according to the Friedman and Wyman classification.

RESULTS. The mean follow-up period was 49 months. Of the femoral neck fractures, 34 united in a mean of 4 months; 33 of them healed anatomically and one with a 6-degree varus angulation. No osteonecrosis of the femoral head was noted. Of the femoral shaft fractures, 32 united in a mean of 6 months, 5 were non-unions (2 persisted even after revision surgery). Seven patients developed infections (5 superficial and 2 deep), which resolved with debridement and antibiotic treatment. Functional results were good in 29 patients, fair in 5, and poor in 3.

CONCLUSION. The use of dynamic hip screws and compression plates for ipsilateral femoral neck and shaft fractures is reliable in achieving bone union with few complications.