Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 1;38(10):541-546.
doi: 10.1097/BOT.0000000000002872.

Incidence of Ipsilateral Femoral Neck and Shaft Fractures in Pediatric and Adolescent Patients

Timothy C Borden  1 , Layla A Haidar  1 , Rohini M Vanodia  1 , Sree M Vemu  2 , Garrett S Dennis  1 , Surya N Mundluru  1 , Lindsay M Crawford  1 , Jessica L Traver  1 , Shiraz A Younas  1 , Joshua L Gary  3 , Mark L Prasarn  2 , Timothy S Achor  1 , John W Munz  1 , Alfred A Mansour  1
Affiliations

Incidence of Ipsilateral Femoral Neck and Shaft Fractures in Pediatric and Adolescent Patients

Timothy C Borden et al. J Orthop Trauma. .

Abstract

Objectives: To identify the incidence, patient characteristics, and effectiveness of radiographic screening methods for detecting ipsilateral femoral neck and shaft fractures in pediatric and adolescent trauma patients.

Design: Retrospective cohort study.

Setting: This study was conducted at a tertiary pediatric trauma hospital.

Patient selection criteria: Patients younger than 18 years treated for a femoral shaft fracture between 2004 and 2018 were reviewed. Pathologic (metabolic bone disease or bone lesion), periprosthetic, and penetrating traumatic femoral shaft fractures were excluded.

Outcome measurements and comparisons: Patient demographics, mechanisms of injury, treatment methods, and associated injuries were analyzed. Pretreatment x-rays and computed tomography (CT) scans were reviewed for the identification of ipsilateral femoral neck and shaft fractures.

Results: Among the 840 pediatric patients included in this study, 4 patients (0.5%) sustained ipsilateral femoral neck and shaft fractures. All the femoral neck fractures were observed in adolescents (aged 13-17 years) and involved in high-energy traumas. In adolescents involved in high-energy trauma, the incidence increased to 1.7%. Pretreatment sensitivity of both x-rays and CT scans was only 50% for the detection of femoral neck fractures.

Conclusions: This study reveals that ipsilateral femoral neck and shaft fractures in pediatric patients are rare, occurring in adolescents involved in high-energy trauma. The findings suggest the need for a selective, rather than routine, use of CT scans based on the patient's age and the mechanism of injury. The use of alternative imaging methods such as magnetic resonance imaging should be considered to balance diagnostic accuracy while minimizing radiation exposure.

Level of evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

PubMed Disclaimer

References

    1. Alho A. Concurrent ipsilateral fractures of the hip and shaft of the femur. A systematic review of 722 cases. Ann Chir Gynaecol. 1997;86:326–336.
    1. Caldwell L, Chan CM, Sanders JO, et al. Detection of femoral neck fractures in pediatric patients with femoral shaft fractures. J Pediatr Orthop. 2017;37:e164–e167.
    1. Hak DJ, Mauffrey C, Hake M, et al. Ipsilateral femoral neck and shaft fractures: current diagnostic and treatment strategies. Orthopedics. 2015;38:247–251.
    1. Watson JT, Moed BR. Ipsilateral femoral neck and shaft fractures: complications and their treatment. Clin Orthop Relat Res. 2002;399:78–86.
    1. Wiss DA, Sima W, Brien WW. Ipsilateral fractures of the femoral neck and shaft. J Orthop Trauma. 1992;6:159–166.