The Journal of Bone and Joint Surgery, Vol 60, Issue 1 112-117, Copyright © 1978 by Journal of Bone and Joint Surgery, Inc
The thigh-lacer: ambulatory non-operative treatment of femoral shaft fractures
WH Crotwell
Thirty patients with fractures of the femoral shaft were treated by closed
reduction, tibial-pin traction for three to six weeks, and early ambulation
with crutches in a plastic thigh-lacer. Extensive quadriceps-strengthening
exercises were performed. When the patient achieved active extension of the
knee against gravity, weight-bearing as tolerated was encouraged. All of
the fractures united. Follow-up ranged from eight to forty months. Malunion
(angulation greater than 10 degrees) occurred in three patients and there
was some loss of knee motion (less than 90 degrees of flexion) in one
patient. Infection, refracture, non-union, and shortening of greater than
two centimeters were not seen. This method of treatment yielded results
comparable to those obtained with cast-bracing, without the high incidence
of loss of knee motion, angulation, and prolonged cast treatment associated
with that form of treatment.