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Double fractures of the femur: a review of 16 patients

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Double ipsilateral femoral fractures account for 1–9% of femoral fractures. There is no clear advantage between single or double implant osteosynthesis. We present a series of patients with double ipsilateral femoral fractures, to address the challenges in treatment, namely the implants for osteosynthesis and complications of treatment.

Materials and methods

We retrospectively studied 16 patients (7 men, 9 women; mean age, 51 years) treated from January 2015 to December 2018. Motor vehicle accidents were the leading cause of injury. Types of fractures were pertrochanteric and shaft (6), pertrochanteric and distal (2), double shaft (3), neck and shaft (2), neck and distal (1), shaft and distal (1), and triple fracture including a pertrochanteric, shaft and distal (1). In five patients, two different implants were used (plate and screws, cannulated hip screws, femoral nail), whereas in 11 patients a long femoral nail was used.

Results

Fourteen patients experienced union at a mean of 3 months (2–6 months). Two patients experienced nonunion: both had plate and screws osteosynthesis. One patient died 15 days after admission from polytrauma and another patient experienced central venous catheter thrombosis and pneumonia. Surgical complications (2 patients) included a thigh skin necrosis, and external fixator pin tract infection/infected non-union. Weight-bearing was delayed in all patients; full weight-bearing was allowed in 11 patients at 4 months postoperatively, and in four patients at 5 months.

Conclusion

Due to the rarity and the difficulty of standardization of double ipsilateral femoral fractures, there is variable information on the optimal osteosynthesis of the fractures and the outcome of the patients. It seems that closed reduction and long hip nailing is the treatment of choice, with few complications.

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No benefits have been or will be received from a commercial party related directly or indirectly to the subject matter of this article.

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Authors and Affiliations

  1. Department of Orthopaedics and Orthopaedic Oncology, University of Padova, Padova, Italy

    Andrea Angelini, Alberto Crimì, Maria Chiara Cerchiaro, Antonio Berizzi & Pietro Ruggieri

  2. First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

    Andreas F. Mavrogenis, Jim Georgoulis, Spyros Sioutis, Achilles Bekos & Vasilios G. Igoumenou

Authors
  1. Andrea Angelini
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  2. Andreas F. Mavrogenis
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  3. Alberto Crimì
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  4. Jim Georgoulis
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  9. Antonio Berizzi
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Correspondence to Andreas F. Mavrogenis.

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Angelini, A., Mavrogenis, A.F., Crimì, A. et al. Double fractures of the femur: a review of 16 patients. Eur J Orthop Surg Traumatol 31, 1345–1354 (2021). https://doi.org/10.1007/s00590-021-02873-w

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  • DOI: https://doi.org/10.1007/s00590-021-02873-w

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