Prevalence of ipsilateral neck of femur fractures among patients with diaphyseal femoral fractures admitted at Muhimbili Orthopaedic Institute

Abstract

ABSTRACT Background Femoral diaphyseal fractures with ipsilateral neck of femur fractures occurs in 1-9% of all femoral diaphyseal fractures. Femoral diaphyseal fractures are observed across all age groups and most frequently in young males after high-energy trauma. The mechanism in young patients tend to be motor vehicle crashes. It reported, 20%-50% combined fracture of femur and femoral neck can be missed on initial investigation if no combined methods of investigation on initial evaluation of all patients with diaphyseal femoral fracture is not followed. Objectives The objective of this study was to determine the proportion of ipsilateral neck of femur fractures in patients with diaphyseal fractures who are admitted at Muhimbili Orthopaedic Institute, Dar es salaam, Tanzania Methodology This was a descriptive cross-sectional study which looked into ipsilateral femoral neck and diaphyseal fractures patients who are admitted at Muhimbili Orthopaedic Institute (MOI) from September 2018 to April 2019. Structured questionnaire was used to collect data from patient who consented. Demographic data, mechanism of injury, category of mechanism injury and radiological images findings of femoral diaphyseal, hip and pelvis were recorded. Data was analyzed by statistical package for the social studies (SPSS) version 24. P-value of 0.05 was considered significant. Results A total of 101 of patients with diaphyseal femoral fracture were enrolled into the study, in which young adult male 82 (81%) with average age of 33.2 years were observed. The prevalence of ipsilateral femoral neck and diaphyseal fracture was 10.9% among 101 patients with diaphyseal femoral fracture admitted at Muhimbili Orthopaedic Institute (MOI). Only one patient making 1% of all patients, was missed in the initial investigation of ipsilateral femoral neck fracture using supplementary radiographic views of the hip. The most cause of mechanism of injury among these patients was motor traffic crash 92.1% of all enrolled patients followed by fall from height 6%. Conclusion The proportional of ipsilateral femoral neck and diaphyseal fracture was found to be higher than in other previous studies. While the missed ipsilateral femoral neck and diaphyseal fracture was low compared to authors elsewhere. Recommendations Ipsilateral femoral neck and diaphyseal fracture should be suspected in all patients sustaining diaphyseal femoral fracture. Additional radiological images like image intensifier and CT scan should be added to in order to detect occult ipsilateral femoral neck and diaphyseal fracture. A similar study should be done of longer duration so have to more power of the proportion of the study.