ABSTRACT
A series of 131 comminuted fractures of the femoral shaft in 123 patients were externally fixed by the ASIF plating method. Of the 126 fractures in 118 patients, that could be reviewed one to 3 years postoperatively, 115 of 92% presented a good functional result. The most common complication was a fatigue fracture of the plates which, however, only occurred after biomechanically faulty application, without medial buttress of the bone, and in the absence of a cancellous autograft. The application of a bone graft therefore appears mandatory in all fractures of the femoral shaft that are fixed by a plate.
Subject(s)
Bone Plates , Femoral Fractures/surgery , Fracture Fixation, Internal , Adolescent , Adult , Aged , Female , Fracture Fixation, Internal/methods , Humans , Male , Middle Aged , Postoperative ComplicationsABSTRACT
A consecutive series of 131 comminuted fractures of the femur in 123 patients has been reviewed. All fractures were stabilized by means of rigid ASIF-plate fixation (mostly DCP). About 60% of the patients were polyfractured or polytraumatized (including brain, chest and abdominal injuries). In 85% of the cases the fracture was stabilized within 24 h after the accident and usually the patients remained on a ventilator with PEEP for 1 to 2 days postoperatively. Of the 4 postoperative deaths only two patients died of a pulmonary complication. All patients could be reexamined 1-3 years postoperatively. Although a number of them had suffered from complications (osteitis, fatigue fractures of the plate, delayed union) and had to be reoperated,92% of the cases displayed an excellent or good functionl result. The factors to reduce the complication rate(i.e. primary cancellous bonegraft) are being discussed.
