The Journal of Bone and Joint Surgery (American). 2008;90:1173.
doi:10.2106/JBJS.9005.ebo3
© 2008 The Journal of Bone and Joint Surgery, Inc.
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Evidence-Based Orthopaedics

Choice of Initial or Definitive Stabilization of Femoral Shaft Fractures Was Affected by Patient Clinical Status

Pape H-C, Rixen D, Morley J, Husebye EE, Mueller M, Dumont C, Gruner A, Oestern HJ, Bayeff-Filoff M, Garving C, Pardini D, M van Griensven, Krettek C, Giannoudis P. EPOFF Study Group. Impact of the Method of Initial Stabilization for Femoral Shaft Fractures in Patients with Multiple Injuries at Risk for Complications (Borderline Patients). Ann Surg. 2007 Sep;246:491-501.[CrossRef][Medline]

The first 150 words of the full text of this article appear below.

Question: In patients with multiple severe injuries, is initial temporary fracture stabilization with external fixation more effective than initial definitive stabilization with intramedullary nailing for femoral shaft fractures?

Design: Randomized (unclear allocation concealment), unblinded controlled trial with in-hospital postoperative follow-up.

Setting: 10 level-I trauma centers in Europe.

Patients: 184 patients, 18 to 65 years of age, with multiple injuries with a New Injury Severity Score of >16 points or 3 extremity injuries with an Abbreviated Injury Scale score of ≥2 points in association with another body-region injury with an Abbreviated Injury Scale score of ≥2 points. All patients had a long-bone midshaft fracture of the lower extremity eligible for antegrade intramedullary fixation. Exclusion criteria included previous polytrauma, body weight >250 lb (113.4 kg), open epiphyseal plates, multiple premorbid conditions (i.e., cardiac or coronary insufficiency, cardiac or lung transplantation, pulmonary hypertension, emphysema, pulmonary disease, previous acute respiratory distress syndrome, . . . [Full Text of this Article]

Robert N. Meek, MD

University of British Columbia
Vancouver, British Columbia, Canada


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