{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:44:53Z","timestamp":1792053893207,"version":"4.4.0"},"reference-count":23,"publisher":"EDP Sciences","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":287,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SICOT-J"],"accepted":{"date-parts":[[2026,8,27]]},"published-print":{"date-parts":[[2026]]},"abstract":"<jats:p>\n                    <jats:italic>Introduction<\/jats:italic>\n                    : Ipsilateral proximal and shaft femoral fractures are rare, high-energy injuries associated with substantial morbidity. Evidence on predictors of adverse outcomes after surgical treatment remains limited.\n                    <jats:italic>Methods<\/jats:italic>\n                    : We conducted a retrospective cohort study at a tertiary trauma center including all skeletally mature patients who underwent surgical treatment for ipsilateral proximal femoral fractures (femoral neck or trochanteric region) associated with femoral shaft fractures between January 2019 and December 2024. The primary outcome was a composite of major complications, including deep surgical site infection, delayed union, nonunion, symptomatic pulmonary embolism, or all-cause mortality. Bivariable analyses were performed to compare patients with and without major complications, followed by multivariable logistic regression to identify independent predictors.\n                    <jats:italic>Results<\/jats:italic>\n                    : Fifty-two patients were included, with a mean age of 41.8\u00a0years and a mean Injury Severity Score (ISS) of 23.1. Major complications occurred in 17 patients (32.7%). The most frequent major complications were all-cause mortality (13.5%) and deep surgical site infection (11.5%). In bivariable analysis, smoking, longer time to definitive treatment, and higher ISS were associated with major complications. In the multivariable model, smoking (adjusted odds ratio [OR] 19.24, 95% confidence interval [CI] 2.78\u2013133.04;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.003) and higher ISS (adjusted OR per point 1.10, 95% CI 1.01\u20131.19;\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.027) remained independently associated with the primary outcome, whereas time to definitive treatment and age did not.\n                    <jats:italic>Conclusion<\/jats:italic>\n                    : Major complications were frequent after surgical treatment of ipsilateral proximal and shaft femoral fractures, affecting nearly one-third of patients. Smoking and greater trauma severity, as measured by ISS, were the main independent predictors of adverse outcomes. These findings highlight the importance of perioperative risk stratification and support smoking as a relevant modifiable risk factor in this setting.\n                  <\/jats:p>","DOI":"10.1051\/sicotj\/2026072","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:55:35Z","timestamp":1792050935000},"page":"71","source":"Crossref","is-referenced-by-count":0,"title":["Smoking and injury severity score predict major complications after surgical treatment of ipsilateral proximal and shaft femoral fractures"],"prefix":"10.1051","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9600-5577","authenticated-orcid":false,"given":"Luis Henrique","family":"Longo","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology, Complexo Hospitalar do Trabalhador","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7358-819X","authenticated-orcid":false,"given":"Weverley Rubele","family":"Valenza","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Complexo Hospitalar do Trabalhador","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2989-4557","authenticated-orcid":false,"given":"Paulo Henrique","family":"Vogt","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Complexo Hospitalar do Trabalhador","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Romano Sampaio","family":"Rezende","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Complexo Hospitalar do Trabalhador","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus Uriel Senna","family":"Klipp","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Complexo Hospitalar do Trabalhador","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrique Rezende","family":"Corral","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Complexo Hospitalar do Trabalhador","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2545-0043","authenticated-orcid":false,"given":"Lucas Cruz","family":"Cepeda","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Complexo Hospitalar do Trabalhador","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6004-2353","authenticated-orcid":false,"given":"Christiano Barbieri de Oliveira","family":"Martoni","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Complexo Hospitalar do Trabalhador","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"250","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"R1","doi-asserted-by":"crossref","first-page":"e448","DOI":"10.5435\/JAAOS-D-17-00497","volume":"26","author":"Jones","year":"2018","journal-title":"J Am Acad Orthop Surg"},{"issue":"3","key":"R2","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.injury.2014.11.021","volume":"46","author":"Boulton","year":"2015","journal-title":"Injury"},{"issue":"5","key":"R3","first-page":"354","volume":"67","author":"Alcaraz","year":"2023","journal-title":"Rev Esp Cir Ortop 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