# Retrograde intramedullary nailing for femoral shaft fracture with ipsilateral dynamic hip screw fixation for femur neck fracture; dual fixation. Case study

## TL;DR

This case study presents a successful treatment for a rare combination of femoral shaft and neck fractures using dual fixation techniques.

## Contribution

The paper introduces dual fixation as a viable treatment option for ipsilateral femoral shaft and neck fractures.

## Key findings

- Dual fixation with retrograde nailing and DHS provided stable fixation in a non-displaced femoral neck fracture.
- The technique minimized soft tissue disruption and allowed for early mobilization.
- The case highlights the potential of this approach for managing complex femoral fractures.

## Abstract

Ipsilateral femoral neck and shaft fractures are rare, high-energy injuries posing diagnostic and management challenges. Optimal treatment strategies remain debated. This case study presents a successful approach using dual fixation with retrograde intramedullary nailing and dynamic hip screw (DHS) fixation.

A 38-year-old male driver presented following a motor vehicle accident with right thigh and hip pain, swelling, and deformity. Radiographic evaluation revealed a transverse femoral shaft fracture combined with an ipsilateral, non-displaced transcervical femoral neck fracture.

Dual fixation with retrograde femoral nailing for the shaft and DHS for the neck offers a stable construct while minimizing soft tissue disruption and potentially facilitating early weight-bearing. While open reduction and internal fixation can lead to complications, our chosen technique aimed to avoid them. Vigilant monitoring for complications like avascular necrosis, nonunion, and infection remains crucial. This case highlights the potential efficacy of dual fixation in achieving favorable outcomes in these complex fracture patterns.

Dual fixation using retrograde intramedullary nailing for femoral shaft fracture and DHS fixation for the ipsilateral femoral neck fracture represents a viable treatment option, especially in non-displaced neck fractures. Further research with larger cohorts is needed to validate these findings and establish definitive treatment guidelines.

•Describes a 38-year-old male with ipsilateral femoral shaft and neck fractures treated with dual fixation•Retrograde intramedullary nailing of the shaft and DHS fixation of the neck achieved stable fixation.•The case suggests dual fixation minimizes soft tissue disruption and may promote early mobilization.•Provides a treatment approach for this challenging combination of fractures, especially with non-displaced neck fractures

Describes a 38-year-old male with ipsilateral femoral shaft and neck fractures treated with dual fixation

Retrograde intramedullary nailing of the shaft and DHS fixation of the neck achieved stable fixation.

The case suggests dual fixation minimizes soft tissue disruption and may promote early mobilization.

Provides a treatment approach for this challenging combination of fractures, especially with non-displaced neck fractures