Fractures of the Femoral Shaft in a Regional Hospital Setting

Abstract

The efficacy of treatment techniques for femoral shaft fractures was reviewed in a regional rural hospital setting. Consecutive primary femoral shaft fractures (150) were managed at a medical center hospital during the period of 1974 through 1979. The treatment method was determined by the attending orthopedic faculty. Each case was evaluated at the time of initial hospital treatment, at 30 days postinjury and at 1 yr postinjury. Patient profiles, methods of injury, types of fracture and associated injuries were reviewed. Choice of operative or nonoperative treatment in the first 30 days was the most important factor in the result at 1 yr. Resutls were graded as good if angulation was 0-5.degree. in the A-P [anterior-posterior] and/or lateral views; fair, 6-10.degree. and poor, > 10.degree. or any need for supplemental surgery to achieve union. Shortening, infection and thrombophlebitis were infrequent in this series. Overall rate of supplemental surgery was 37% for the initially nonoperative treated femoral shaft fractures. In this series operative intervention gave surer results with an earlier return to full ambulation and more anatomic repair than nonoperative methods.