MAGNITUDE OF FRACTURE NECK OF FEMUR IN PATIENTS WITH IPSILATERAL FRACTURE SHAFT OF FEMUR IN ADULT

Background: Magnitude of fracture neck of femur associated with ipsilateral fracture shaft of femur is rare and challenging in terms of diagnosis and management. Fracture neck of femur is associated with 0.8-9 % of ipsilateral fracture shaft of femur. Fracture neck of femur is often missed preoperatively with incidence ranging from 20-50%. This study was done with an objective of assessing the magnitude of fracture neck of femur in patients with ipsilateral fracture shaft of femur. Methods: This was descriptive study of retrospective data of 187 fracture shaft of femur. Data from all the patients with fracture shaft of femur in the age group of 17 to 70 years admitted and operated between September 2018 to September 2022 were analyzed with magnitude of ipsilateral fracture neck of femur diagnosed preoperatively or postoperatively as main variable. Descriptive statistics was used to calculate frequency and percentage. Results: Out of 187 fracture shaft of femur, 8.02% (n=15) cases were associated with ipsilateral fracture neck of femur. 73.33% (n=11) cases of fracture neck of femur were identified preoperatively on plain radiograph whereas diagnosis of 26.66% (n=4) cases of fracture neck of femur was missed on initial evaluation and diagnosed on postoperative plain radiograph. Conclusions: Current study showed the magnitude of fracture neck of femur as 8.02% associated with ipsilateral fracture shaft of femur. Careful clinical evaluation, proper radiography of hip, possible CT scan in doubtful cases and intraoperative fluoroscopic evaluation of hip may decrease the incidence of missed diagnosis.