Occult femoral neck fractures in ipsilateral femoral shaft and patellar fractures: A case series about diagnostic challenges and proposed strategies.

Yu-Chao Lin, Wei-Long Lin, Jun-Lin Liu, Yu-Dong Huang, Xiao-Hua Zheng

Abstract readCase Reports

In one paragraph

Article in Trauma case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Yu-Chao LinThe 95th Hospital of Putian, No. 485, Dongyan Road, Licheng District, Putian City, Fujian Province, 351100, China1Present address.

Wei-Long LinThe 95th Hospital of Putian, No. 485, Dongyan Road, Licheng District, Putian City, Fujian Province, 351100, China1Present address.

Jun-Lin LiuSichuan University West China Hospital Tibet People's Government in Chengdu Office Branch, No. 20, Ximianqiao Hengjie, Wuhou District, Chengdu City, Sichuan Province, 610041, China.

Yu-Dong HuangThe 95th Hospital of Putian, No. 485, Dongyan Road, Licheng District, Putian City, Fujian Province, 351100, China1Present address.

Xiao-Hua ZhengThe 95th Hospital of Putian, No. 485, Dongyan Road, Licheng District, Putian City, Fujian Province, 351100, China1Present address.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This case series presents two patients with high-energy trauma resulting in ipsilateral femoral shaft and patellar fractures. Preoperative CT imaging suggested a bone cyst but failed to detect an associated femoral neck fracture, which was also missed during intraoperative fluoroscopy and identified only on postoperative review. Both patients underwent revision surgery involving repositioning of the proximal intramedullary nail locking screws to achieve fixation directed into the femoral neck. At the 6-month follow-up, fracture healing was satisfactory with no signs of avascular necrosis of the femoral head. This report highlights the risk of missed occult femoral neck fractures in high-energy trauma and proposes a diagnostic workflow including MRI screening for femoral neck injury in cases of high-energy lower limb trauma. The efficacy of revision nailing with recon locking is also demonstrated.

Indexed as

Femoral shaft fractureIntramedullary nailingIpsilateralMissed diagnosisOccult femoral neck fracturePatellar fractureRevision surgery

Identifiers

PMID41333994

DOI10.1016/j.tcr.2025.101260

PMCPMC12666842

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