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. 2013 Dec;1(2):59-63.
Epub 2013 Dec 15.

Injuries associated with femoral shaft fractures with special emphasis on occult injuries

E Carlos Rodriguez-Merchan  1 , Luis Moraleda  1 , Primitivo Gomez-Cardero  1
Affiliations

Injuries associated with femoral shaft fractures with special emphasis on occult injuries

E Carlos Rodriguez-Merchan et al. Arch Bone Jt Surg. 2013 Dec.

Abstract

Background: Fractures of the femoral shaft are mostly the result of high-energy accidents that also cause multiple trauma injuries, in particular ipsilateral knee and hip injuries. The purpose of this study was to investigate the incidence of injuries associated with femoral shaft fractures and how many of them were undetected.

Methods: We studied 148 patients (150 femoral shaft fractures) with an average age of 52 (range: 18-97). Femoral shaft fractures were treated with antegrade intramedullary nailing in 118 cases (78.7%), and with open reduction and internal fixation in 32 cases (21.3%). Unlocked reamed intramedullary nailing was performed in Winquist type I and type II fractures, while statically locked unreamed intramedullary nailing was carried out in Winquist type III and type IV fractures.

Results: There were 70 patients with associated injuries (46.4%). The associated injuries went undetected in 18 out of 70 patients (25.5%). Six femoral nonunions (4%) occurred in patients under 70 years of age (high-energy accidents) treated by open reduction and internal fixation.

Conclusion: Injuries associated with femoral shaft fractures were very frequent (46.4%) in our series, with 25.5% undetected. Open reduction and internal fixation was a poor prognostic factor of nonunion in these fractures.

Keywords: Associated injuries; Diaphysis; Femur; Fracture; Treatment.

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Figures

Figure 1.
Figure 1.
Patient with diaphyseal femoral fracture after a traffic accident. Six months later, after complaining from chronic knee pain, MRI of the ipsilateral knee was performed showing a fracture of the lateral tibial plateau (A). The fracture was treated with open reduction and internal fixation, with a satisfactory result (B, C: preoperative and postoperative x-rays).
Figure 2.
Figure 2.
Patient with diaphyseal femoral fracture after a high-energy accident (A). Eight months after the fracture, ipsilateral knee MRI was performed when the patient complained of knee instability. The absence of ACL (B) could be observed, suggesting chronic tearing (C). A bone-tendon-bone ACL patellar tendon autograft reconstruction was performed 1 month after diagnosis of the ACL tear.
See this image and copyright information in PMC

References

    1. Salminen ST, Pihlajamaki HK, Avikainen VJ, Bostman ON. Population based epidemiologic and morphologic study of femoral shaft fractures. Clin Orthop Relat Res. 2000;372:241–9. - PubMed
    1. Regel G, Lobenhoffer P, Grotz M, Pape HC, Lehmann U, Tscherne H. Treatment results of patients with multiple trauma: an analysis of 3406 cases treated between 1972 and 1991 at a german level I trauma center. J Trauma. 1995;38:70–8. - PubMed
    1. Bengner U, Ekbon T, Johnell O, Nilsson DE. Incidence of femur and tibial shaft fractures, epidemiology 1950-1983 in Malmo Sweden. Acta Orthop Scand. 1994;61:251–4. - PubMed
    1. Arneson TJ, Malton III LJ, Lewallen DG, O'Fallon WN. Epidemilogy of diaphyseal and distal femoral fractures in Rochester Minnesota, 1965-1984. Clin Orthop Relat Res. 1988;234:188–94. - PubMed
    1. Winquist RA, Hansen ST, Clawson DK. Closed intramedullary nailing of femoral fractures: a report of five hundred and twenty cases. J Bone Joint Surg Am. 1984;66-A:529–39. - PubMed

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