Journal List > J Korean Orthop Assoc > v.14(3) > 1124212

Kim and Lee: Clinical Study on the Femoral Fractures

Abstract

Fractures of the femur are one of the most frequent injuris which Orthopedic Surgeons are called upon to treat. The incidence of femoral fractures has risen by the results of rapid increase in traffic accident, industrial accident, and prolongation of life expectancy in adults. Two hundred and ninty eight consecutive femur fractures were treated at the Department of Orthopedic Surgery, Hanyang University, during the period of May 1972 to September 1977 were reviewed. The results were as follows; 1. The fractures occured commonly in the 6 to 10 years age group (46.1%) in children and in the 21 to 40 years age group (48.2%) in adults. Males comprised 217 cases (71.1%). 2. Fractures were caused by traffic accident (72.2%) mainly and especially in old aged fractures of the femoral neck and intertrochanter were caused by fell down from a height. 3. Closed fractures were 258 cases (84.7%) and transversefractures were the most common type in, children, and comminuted fractures were the most common type in adults. 4. The freguent fracture site was transcervical fracture of femoral neck, type 3.4 (by Tronzo) of the. intertrochanteric fracture and middle third of femoral shaft. There were no differences between medial and lateral femoral condyle fractures. 5. Associated injuries were common in young adults in 165 cases and in order of frequency, these were fractures of the tibia and fibula, pubics, skulls, patella and ribs etc. 6. Better results were obtained with conservative treatment in children and operative treatment in adults. 7. The period of bony union in children was 7.6 weeks with Bryants traction 9.3 weeks with Russel traction, 8.6 weeks with cast immobilization, 10 weeks with 90-90 skeletal traction and 10.8 weeks with Bohler-braun skeletal traction. 8. The period of bony union in adults was 17 weeks with Kuntscher nail, 13.6 weeks with compression plate and screw fixation, 18 weeks with Bohler-braun skeletal traction and 19weeks with cast brace in femoral shaft fracture. 9. Complications were much more frequent in adults than in children and it were treated well Postoperative infection was occured in 5 cases (1.7%) and they cured well with sequestrectomy, curettage and continuous antibiotics administration. 10. The Bryants traction under 2 years of age, 90-90 skeletal traction over 5 years of age in children and compression plate and screw fixation in adults were further recommended.

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