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Results for “FEMORAL FRACTURES”

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PubMed1994

Treatment of femoral fracture with nonunion.

Thirty-four patients with femoral nonunion were managed by autogenous and/or allogenous bone graft alone, or internal fixation (including DCP or intramedullary nail) combined with bone graft, or external fixation in Taichung Veterans General hospital. Adequate follow-up study was obtained in 32 patients; two patients were unable to be contacted for follow-up. All 32 patients had received one or more operations. All but four patients showed clinical and radiological union, with an overall union rate 87.5%. Twenty-five patients (89.3%) returned to work, but half of these patients changed jobs. All twenty-eight patients with solid unions could walk, but eleven patients (39.3%) had a slight limp. Twenty-two patients (78.6%) could squat, and all patients could straighten their knees. Fourteen patients (50%) complained of occasional soreness over the operated area. In our limited experience, most femoral nonunions result from (1) inappropriate selection and usage of internal fixator, (2) severe stripping of soft tissue around the fracture site, or inappropriate usage of cerclage wire, and (3) infection. Treatment must depend on the causes and types of nonunion. In this study, a high union rate and good functional recovery were achieved with interlocking nails with or without autogenous bone graft. Plating would extend the time for union to take place, and even resulted in refracture of the plate by contact with the medial cortex when there was no medial buttress. In general, detailed planning before operation, skilled surgical techniques and aseptic procedures are essential in the prevention and treatment of nonunion.

Adolescent↗
PubMed1993

Immediate internal fixation of low-velocity gunshot-related femoral fractures.

Fractures caused by gunshots are increasingly common in urban hospitals and trauma centers. The rising incidence and complexity of these injuries present difficult management problems and health care burdens. In a 3-year period, from 1989 through 1991, 21 patients with femoral shaft fractures from low-velocity bullets were treated with intramedullary fixation within 15 hours of admission. Eighteen patients were available for follow-up. The fractures had healed in all patients. Average hospitalization for an isolated injury was 7 days. There were no complications related to immediate internal fixation. Immediate internal fixation of femoral shaft fractures caused by low-velocity gunshots can be performed in an efficient and cost effective manner.

Adolescent↗
PubMed1992

Peroneal nerve palsy after early cast application for femoral fractures in children.

The incidence and contributing factors associated with post-casting peroneal nerve palsy were examined in a series of 110 consecutive pediatric femoral shaft fractures treated with early hip spica cast application. Four patients with peroneal nerve palsy were identified. All four had 90 degrees/90 degrees casts placed and underwent cast wedging for alignment. All palsies resolved with immediate cast removal. Other treatment options for certain femur fractures with significant initial shortening should be considered. We advise pre- and post-cast neurologic examination and avoidance of forceful distraction. Fracture manipulation, through wedging, should be delayed.

Casts, Surgical↗