Descriptive Analysis Of Femur Fracture Patterns, Management And Outcome: Descriptive Observational Study From A Level 1 Trauma Center
Abstract Background We aimed to assess the patterns, associated injuries, management and outcome of traumatic femoral fractures.Methods This retrospective study was conducted to include all trauma patients with femoral shaft fractures admitted in a level 1 trauma center between January 2012 and December 2015. Data were analyzed and compared according to the time to intramedullary nailing; mechanisms of injury and age groups.Results A total of 605 cases were analyzed, with mean age of 30.7±16.2 years.The majority of fractures were unilateral (96.7%) and 91% were closed fractures. Three-fourth of fractures were treated by reamed intramedullary nailing (rIMN); antegrade in 80%. The pyriform fossa nails were used in 71.6% while trochanteric entry nails was used in 28.4%. Forty five (8.9%) of fractures were treated with external fixator, 37 (6.1%) had conservative management. Victims of traffic-related accidents were younger, sustained severe injuries, and more likely to have rIMN and required more blood transfusion. Traffic-related injuries occured more in patients aged 14-30 years whereas; injuries related to fall were significantly higher in patients aged 31-59 years. Thirty-one patients (7.8%) had rIMN < 0-6 h, 106 (25.5%) had rIMN < 6-12 h and 267 (66.8%) had rIMN > 12 h. The implant type, duration of surgery, DVT prophylaxis, in-hospital complications and mortality were comparable among the three treatment groups.Conclusions the frequency of femoral fracture is 11% mainly in severely injured young males by traffic-related accidents and falls. Further multicenter studies are needed.