Plating of femoral shaft fractures

ABSTRACT

67 femoral shaft fractures were treated by AO plating at Assiut University Hospital, Orthopaedic Department in the period from 1984 to 1987, 63 patients could be followed. There were 61 males and 6 females. Age ranged from15 to 70 years, Average of 33.8 years, twenty nine patients [43.2%] were between 15-30 years. There were 3 open fractures grade 1. 19 patients sustained other injuries with the femoral shaft and 7 cases required operations other than the femoral plating. Five types of fractures could be identified. 51 fractures [76.1%] were fixed within 3 weeks of injury. 16 fractures [23.8%] were fixed more than 3 weeks after injury. Primary cancellous graft was added in 26 fractures [38.9%]. The fixation was done with an AO broad DC in every case. The smallest one had 8 holes and the longest 18 holes obtaining at least a hold on 8 cortices on either side of the fracture. Additional interfragmentary screws were employed when ever necessary. One graft was used liberally mainly in cases with comminution of medial cortical deficiency. The shortest period for union was 2 months and the longest was 22 months [an average of 5.79 months], and 48 patients [85%] achieved union within the first 6 months. Healing time was found to be longer in comminuted fractures than in two fragment fractures and it was found to be earlier when the reduction was perfect than when it was approximate. The complications, were only one patient died on the tenth post operative day because of pulmonary embolism and 7 patients developed local complications [11.11%]. The infection was in one case [1.58%]. The overall results were graded; excellent in 59 patients [93.6%] and good in 4 patients [6.3%] fair and poor results in none of patients