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The Journal of Bone and Joint Surgery, Vol 71, Issue 3 336-340, Copyright © 1989 by Journal of Bone and Joint Surgery, Inc
Early versus delayed stabilization of femoral fractures. A prospective randomized study
LB Bone, KD Johnson, J Weigelt and R Scheinberg
Division of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas 75235-9031.
A prospective randomized study comparing the results of early with delayed
reduction and stabilization of acute femoral fractures in adults was
performed over a two-year period in 178 patients. Only patients who were
more than sixty-five years old and had a fracture of the hip were excluded.
Arterial blood gases, injury-severity score at the time of admission,
pulmonary function, days in the hospital, days in the intensive-care unit,
and hospital costs were recorded for all patients. The patients were
divided into two groups: those who had an isolated fracture of the femur
and those who had multiple injuries. When stabilization of the fracture was
delayed in the patients who had multiple injuries, the incidence of
pulmonary complications (adult respiratory-distress syndrome, fat embolism,
and pneumonia) was higher, the hospital stay was longer, and the number of
days in the intensive-care unit was increased. The cost of hospital care
showed a statistically significant increase for all patients who had
delayed treatment of the fracture compared with those who had early
stabilization.
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