Retrograde intramedullary nailing for femoral shaft fracture with ipsilateral dynamic hip screw fixation for femur neck fracture; dual fixation. Case study.

INTRODUCTION

Ipsilateral femoral neck and shaft fractures are rare, high-energy injuries posing diagnostic and management challenges. Optimal treatment strategies remain debated. This case study presents a successful approach using dual fixation with retrograde intramedullary nailing and dynamic hip screw (DHS) fixation.

CASE PRESENTATION: A 38-year-old male driver presented following a motor vehicle accident with right thigh and hip pain, swelling, and deformity. Radiographic evaluation revealed a transverse femoral shaft fracture combined with an ipsilateral, non-displaced transcervical femoral neck fracture.

DISCUSSION: Dual fixation with retrograde femoral nailing for the shaft and DHS for the neck offers a stable construct while minimizing soft tissue disruption and potentially facilitating early weight-bearing. While open reduction and internal fixation can lead to complications, our chosen technique aimed to avoid them. Vigilant monitoring for complications like avascular necrosis, nonunion, and infection remains crucial. This case highlights the potential efficacy of dual fixation in achieving favorable outcomes in these complex fracture patterns.

CONCLUSION

Dual fixation using retrograde intramedullary nailing for femoral shaft fracture and DHS fixation for the ipsilateral femoral neck fracture represents a viable treatment option, especially in non-displaced neck fractures. Further research with larger cohorts is needed to validate these findings and establish definitive treatment guidelines.