Diagnosis of Femoral Neck Fractures in Patients with a Femoral Shaft Fracture

Abstract

In the presence of a femoral shaft fracture, evaluation of the femoral neck with fine-cut computed tomography and dedicated internal rotation hip radiographs significantly improves the ability to diagnose an associated femoral neck fracture.

Is Reconstruction Nailing of All Femoral Shaft Fractures Cost Effective? A Decision Analysis

“…As a base model from literature review, we assumed that 5% of shaft fractures had an ipsilateral femoral neck fracture, and 37% were missed and required further surgery and its associated costs and complications. [1][2][3][4][5][6]9,13,14,[18][19][20][21] The rates of ipsilateral neck and shaft fractures and of missed femoral neck fractures and the probabilities of complications of missed and treated femoral neck fractures were obtained from the literature and were averaged using a weighted average. 3,4,8 The rates of avascular necrosis and nonunion were combined as complications, and this weighted average was used as the base rate in the model.…”

“…This cost estimate was based on the retail cost of the 2 titanium cannulated screws and additional operating time. We assigned a 1% risk of intraoperative femoral neck fracture using the rates available in Tornetta et al 5 …”

“…[1][2][3][4][5][6] From the literature, it has been observed that between 19% and 55% of associated femoral neck fractures are missed with plain films and 5%-22% with computed tomography (CT) scans. [5][6][7] It is unknown as to how many of these missed femoral neck fractures are nondisplaced, how many might be caused by the passage of the femoral nail, and a number of these fractures are not identified until the patient has left the operating room. Cannada et al 8 reported a 22% missed femoral neck fracture rate preoperatively and 14% postoperatively, even when treated by experienced orthopedic trauma surgeons.…”

Alt Ekstremite Travmasi

“…Ancak kı-rığa bağlı rotasyonel deformite kuşkusu varsa BT ile değerlendirme gerekir. Eşlik eden femur boyun kırıkları veya pelvik lezyonların atlanmaması için internal rotasyonda AP pelvis grafisi, kalça tomografisi, cerrahi öncesi floroskopi ile lateral grafinin değerlendirilmesi ve cerrahi sonrası mutlaka AP pelvis grafisinin çekilmesi önerilmiştir [11].…”

Treatment of femoral neck fractures in physiologically young adults

“…2 Therefore, recent research has focused on identifying nondisplaced femoral neck fractures at presentation through the institution of a standard protocol for evaluation of patients with femoral shaft fractures. 3 Tornetta et al 3 reduced the delay in femoral neck fracture diagnosis by 91% from the previous year at their institution through a protocol that consisted of a dedicated anteroposterior internal rotation plain radiograph of the hip, a fine (2-mm) cut CT scan through the femoral neck, and an intraoperative fluoroscopic lateral radiograph before fixation. The protocol also included postoperative anteroposterior and lateral hip radiographs in the operating room before patient awakening.…”