Ipsilateral Femoral Neck and Shaft Femur Fracture in a Child: Nonoperative Management
Published: September 1, 2019 | DOI: https://doi.org/10.7860/JCDR/2019/42177.13158
Manoj Aggarwal, Kunal Kishore, Chirag Arora, Sanjay Pandey, Vishal Kumar
1. Consultant, Department of Orthopaedics, Gaurav Fracture Clinic, Patna, Bihar, India.
2. Assistant Professor, Department of General Surgery, Narayan Medical College, Jamuhar, Bihar, India.
3. Senior Resident, Department of Orthopaedics, PGIMER, Chandigarh, India.
4. Associate Professor, Department of PMR, AIIMS, Patna, Bihar, India.
5. Assistant Professor, Department of Orthopaedics, PGIMER, Chandigarh, India.
Correspondence
Chirag Arora,
#C2/74; Ashok Vihar Phase II, Opp. Deep Market, New Delhi-110052, India.
E-mail: aro.chirag@gmail.com
Concomitant ipsilateral fractures of the neck and shaft of femur are a rare occurrence in childhood. Only 14 cases have been reported to date, the most common fracture pattern being Delbet Type III and a spiral fracture of midshaft femur. A four-year-old boy presented with closed fracture shaft femur and chest trauma (2-8th rib fractures right side with underlying haemopneumothorax), fracture neck femur was incidentally detected on pelvic radiographs. Initially, he was managed according to ATLS protocols, surgical management of lower limb was deferred till vitals stabilised. Later child was managed nonoperatively in view of persistent poor chest condition with one and half hip spica cast. Successful clinic-radiological union was noted at 24 months. We should have a high index of suspicion for proximal femur fractures especially in a child with multiple organ injuries.
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