Injuries Associated with Femoral Shaft Fractures with Special Emphasis on Occult Injuries

  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 ۱۴۸ patients (۱۵۰ femoral shaft fractures) with an average age of ۵۲ (range: ۱۸-۹۷). Femoral shaft fractures were treated with antegrade intramedullary nailing in ۱۱۸ cases (۷۸.۷%), and with open reduction and internal fixation in ۳۲ cases (۲۱.۳%). 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 ۷۰ patients with associated injuries (۴۶.۴%). The associated injuries went undetected in ۱۸ out of ۷۰ patients (۲۵.۵%). Six femoral nonunions (۴%) occurred in patients under ۷۰ years of age (high-energy accidents) treated by open reduction and internal fixation. Conclusion: Injuries associated with femoral shaft fractures were very frequent (۴۶.۴%) in our series, with ۲۵.۵% undetected. Open reduction and internal fixation was a poor prognostic factor of nonunion in these fractures.

Keywords:

Associated injuries , Diaphysis , Femur , Fracture , Treatment