Operative management of ipsilateral fractures of the hip and femur.

Thirteen patients with ipsilateral hip and femoral shaft fractures are discussed. In nine patients, the femoral shaft fracture was managed by a combination of dynamic compression plating with a medial cancellous bone graft and either multiple cancellous screws or a dynamic hip screw for the proximal fracture (Group I). Four patients had Ender pin fixation (Group II). In Group I, both fractures were united within 16 weeks in all patients, and at least 90% of normal hip and knee motion was regained. Nonunions developed in two of the four Group II patients. Immediate separate fixation of ipsilateral hip and femoral shaft fractures allows definitive management of the proximal fracture and immediate mobilization without external support and provides satisfactory results with a low complication rate.