PDF(Pubmed)
Abstract：
UNASSIGNED: Ipsilateral proximal, shaft, and distal femur fractures are extremely uncommon. It might be challenging and contentious to treat ipsilateral multi-level femur fractures. There are still unanswered questions regarding the order of fracture types that should be repaired first and the type of implant that should be used.
METHODS: A twenty-nine-year-old male patient was assessed at the emergency department after a motorcycle accident. The patient had a clearly deformed left lower extremity and was complaining of pain in the left thigh. Preoperative radiographs revealed ipsilateral multi-level femur fracture on the left thigh involved basicervical fracture of femur (AO/OTA 31-B3) with transverse shaft fracture of femur (AO/OTA 32-A3) and extra articular supracondylar femur fracture (AO/OTA 33-A2).
UNASSIGNED: First, we performed proximal femur nail antirotation in order to stabilize the fracture of the femur neck and reduce the incidence of nonunion and avascular necrosis of the femoral head in young adults. The next step to fix the shaft and distal femur fracture was to perform the distal femur locking plate. The EQ5D and Harris Hip Score questionnaires showed improvement after implementing these procedures.
CONCLUSIONS: Ipsilateral multi-level femur fractures have challenges and controversies in their management. In this situation, proximal femur nail antirotation and distal femur locking plates are viable options due to the condition of the injury and the higher risk of negative effects. After all fractures have been fixed, it is important to closely monitor the hip and knee joints to avoid stiffness or contracture.
METHODS: A twenty-nine-year-old male patient was assessed at the emergency department after a motorcycle accident. The patient had a clearly deformed left lower extremity and was complaining of pain in the left thigh. Preoperative radiographs revealed ipsilateral multi-level femur fracture on the left thigh involved basicervical fracture of femur (AO/OTA 31-B3) with transverse shaft fracture of femur (AO/OTA 32-A3) and extra articular supracondylar femur fracture (AO/OTA 33-A2).
UNASSIGNED: First, we performed proximal femur nail antirotation in order to stabilize the fracture of the femur neck and reduce the incidence of nonunion and avascular necrosis of the femoral head in young adults. The next step to fix the shaft and distal femur fracture was to perform the distal femur locking plate. The EQ5D and Harris Hip Score questionnaires showed improvement after implementing these procedures.
CONCLUSIONS: Ipsilateral multi-level femur fractures have challenges and controversies in their management. In this situation, proximal femur nail antirotation and distal femur locking plates are viable options due to the condition of the injury and the higher risk of negative effects. After all fractures have been fixed, it is important to closely monitor the hip and knee joints to avoid stiffness or contracture.
摘要：
■同侧近端，轴,股骨远端骨折极为罕见.治疗同侧股骨多层骨折可能具有挑战性和争议性。关于应首先修复的骨折类型的顺序和应使用的植入物的类型，仍然存在未回答的问题。
方法：一名29岁的男性患者在一次摩托车事故后在急诊科进行了评估。患者左下肢明显变形，并抱怨左大腿疼痛。术前X线片显示，左大腿同侧股骨多节段骨折涉及股骨基颈骨折（AO/OTA31-B3），股骨横骨干骨折（AO/OTA32-A3）和关节外股骨髁上骨折（AO/OTA33-A2）。
■首先，我们进行了股骨近端防旋髓内钉,以稳定年轻成人股骨颈骨折并降低股骨头骨不连和缺血性坏死的发生率.固定轴和股骨远端骨折的下一步是执行股骨远端锁定钢板。实施这些程序后，EQ5D和Harris髋关节评分问卷显示出改善。
结论：同侧股骨多节段骨折在治疗方面存在挑战和争议。在这种情况下,股骨近端防旋髓内钉和股骨远端锁定钢板是可行的选择，因为损伤的情况和较高的负面影响风险。在所有骨折都固定好之后,密切监测髋关节和膝关节以避免僵硬或挛缩是很重要的。
方法：一名29岁的男性患者在一次摩托车事故后在急诊科进行了评估。患者左下肢明显变形，并抱怨左大腿疼痛。术前X线片显示，左大腿同侧股骨多节段骨折涉及股骨基颈骨折（AO/OTA31-B3），股骨横骨干骨折（AO/OTA32-A3）和关节外股骨髁上骨折（AO/OTA33-A2）。
■首先，我们进行了股骨近端防旋髓内钉,以稳定年轻成人股骨颈骨折并降低股骨头骨不连和缺血性坏死的发生率.固定轴和股骨远端骨折的下一步是执行股骨远端锁定钢板。实施这些程序后，EQ5D和Harris髋关节评分问卷显示出改善。
结论：同侧股骨多节段骨折在治疗方面存在挑战和争议。在这种情况下,股骨近端防旋髓内钉和股骨远端锁定钢板是可行的选择，因为损伤的情况和较高的负面影响风险。在所有骨折都固定好之后,密切监测髋关节和膝关节以避免僵硬或挛缩是很重要的。
