The Dashboard Femoral Fracture

Pathomechanics, Treatment, and Prevention

¹ Orthopaedic Service, Walter Reed Army Hospital, Walter Reed Army Medical Center, Washington, D.C.

The dashboard femoral fracture is an injury unique to high-speed automobile accidents. Thirty fractures of this type are reported, analyzed, and evaluated as to end result. The fracture conformation is characteristic and the etiological forces are constant. Great care must be exercised so that hip and knee injuries, associated with obvious shaft fracture of this type, will not be overlooked.

The femoral-shaft fracture is best. managed conservatively in skeletal traction with constant supervision to prevent femoral shortening. Open surgical treatment of associated ligament tears of the knee and femoral-neck fractures is recommended, but this surgery does not alter the indication for conservatism in management of the femoral-shaft fracture. In spite of the magnitude of this injury, favorable results can he anticipated, in a reasonable period of time, with conservative management.

Prevention of this injury requires safety engineering of automobiles and highways. Proper construction of the instrument panel and the installation of seat. belts to allow controlled deceleration on impact are both feasible and economical. The wearing of seat belts specifically prevent dashboard injury to the femur, knee, and hip, but on jackknifing, will not prevent other associated injuries. The removal of roadside impact objects, the construction of widely separated dual-highways, and the planting of the low roadside shrubbery are recommended to reduce the number of head-on collisions, which cause so many highway deaths, as well as this formidable dashboard injury.

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