Segmental and comminuted segmental femoral shaft fractures - a study of 33 cases

ABSTRACT

The results of a study of 33 cases of segmental and comminuted segmental femoral shaft fractures, treated under our care from January 1980 to December 1985, are presented and analysed. This paper provides a useful classification of this type of injury and compares the results of different types of treatment. Depending upon the severity of comminution, these fractures have been classified into segmental fractures, split segmental fractures, and multifragmented segmental fractures. In this study 13 cases were treated by traction, six cases by AO intramedullary nail, nine cases by AO condylar plate and five cases by AO external fixator. By analyzing the results of different methods of treatment, it was found that segmental and split segmental fractures are best treated by internal fixation. Displaced unstable multifragmented segmental fractures are best treated by external fixation, while undisplaced stable fractures are best treated by traction. Cases of segmental and split segmental fractures, treated by traction, had unsatisfactory results because of angulation and shortening