Closed Reduction and Early Cast-Brace Ambulation in the Treatment of Femoral Fractures

PART I: AN In Vivo QUANTITATIVE ANALYSIS OF IMMOBILIZATION IN SKELETAL TRACTION AND A CAST-BRACE

¹ From the Departments of Orthopedic Surgery and Biomedical Engineering, School of Medicine, Vanderbilt University, and Veterans Administration Hospital, Nashville

Measurements of axial rotation and translation of the fragments in thirty patients with fractures of the femoral shaft and condylar regions, using a specially designed electrogoniometer and cineroentgenography, were made while patients were in bed (in skeletal traction, in suspension without traction, and in a cast-brace), and while they walked in a cast-brace. Rotation in bed was less in the cast-brace than in traction or suspension, and with two exceptions was less walking in the cast-brace than in traction in bed. Translation during weight-bearing in the cast-brace was least with the supracondylar-intercondylar and mid-shaft comminuted fractures, and most with the mid-shaft transverse fractures. Based on these observations, we concluded that closed reduction and early ambulation in a cast-brace are best suited for fractures in the distal part of the femur and for comminuted multifragmented fractures in the middle and proximal part of the shaft.

CiteULike    Connotea    Del.icio.us    Technorati    What's this?