Early clinical protocols for traumatic bilateral femoral shaft fracture / 中华创伤杂志

ABSTRACT

Objective To investigate the mechanism,injury characteristics,and early interventions of bilateral femoral shaft fracture.Methods Twenty-five cases of bilateral femoral shaft fracture treated between December 2009 and June 2012 were enrolled in the study.Eighteen patients were males and 7 were females with mean age of 31.2 years (range,17-40 years).Nineteen cases were injured due to traffic accidents and 6 due to the hit by heavy objects.There were 47 sides with closed fracture and 3 sides with open fracture.Intramedullary nailing was performed at 32 sides and plate fixation was used at 18 sides.ISS,blood routine,some blood biochemical items,blood or plasma use,and hospitalization days were measured.Results ISS was (14.6 ± 5.2) points.Preoperative readiness time and hospital stay were (10.1 ± 3.7) days and (28.9 ± 8.4) days respectively.After hospitalization,measured values were (3.0 ± 0.4) × l012/L for red blood cells,(86.0 ± 13.5) g/L for hemogIobin,(47.0 ± 10.6) g/L for total protein,(31.4 ± 6.5) g/L for albumin,(124.1 ± 95.1) U/L for aspartate aminotransferase,(114.2 ± 107.1) U/L for alanine aminotransferase,and (1 848.7 ± 1 044.8) U/L for creatine kinase with significant differences from the reference ranges (P ＜ 0.05 or 0.01).Amount of blood transfused for 23 cases was (1 444.4 t 726.5) ml and plasma transfused for 19 cases was (305.6 ± 98.3) ml before operation.Volume of intra-and post-operative blood transfusion was (2 005.7 ± 1 153.1) ml.Conclusions Stabilization of vital signs predominates the early treatment of bilateral femoral shaft fracture.After the condition is stable,intramedulary nailing or plating can be performed concurrently.