Abstract
Between the years 1994 and 2008, 171 ipsilateral fractures were operatively treated in 169 patients with an average age of 56 years (range, 21-97 years). There is no generally accepted classification of ipsilateral fractures of the femur.
Therefore, we used our own classification that proved useful in evaluation of the group of patients. We only slightly modified it in terms of the findings.
Type III and type IV fractures have a number of characteristic features in common and so we decided to cover them by one type of complex fractures extending from the femoral neck base as far as the femoral shaft. There is no consensus concerning the treatment.
In addition, the percentage of complications is quite high. The group was treated almost exclusively with the reconstruction nail.
In 2 % we used another method of internal fixation. Our results do not differ from those reported by other authors.
In case of fractures of the femoral shaft, in high-energy trauma particularly, it is necessary to check the patient for a potential proximal femur fracture. The diagnosis should be made on the basis of a radiograph of the pelvis in internal rotation and axial projection and CT scans for evaluation of the proximal femur, including 2D CT reconstructions.
Prior to nailing of the femoral shaft, sciascopic examination must be made of the hip in both projections. Fixation by a reconstruction nail is a suitable method for treatment of ipsilateral fractures.
We consider the risk of complications adequate to the mechanism of injury and its severity.