Simultaneous bilateral femoral fractures: systemic complications in 14 cases

We have retrospectively reviewed 14 patients with bilateral femoral shaft fractures who attended our institution between January 1993 and March 1999. The mean age of the patients was 38 years (19-75) and the median injury severity score (ISS) was 16 (interquartile range 10-20). Thirteen patients were treated with intramedullary nailing and 1 with plating and nailing within 24 h of admission to hospital. The mean resuscitation requirements were 10.6 (6-16) litres of colloid and crystalloid and 8.6 (4-30) units of blood. The mean intensive care unit/high dependency unit (ICU/HDU) stay was 4 days (1-14) and the mean hospital stay was 36.3 days (3-210). There were 6 cases of adult respiratory distress syndrome (ARDS), 1 compartment syndrome, 1 case of osteomyelitis, 1 above-knee amputation and 2 deaths (14.2%). The mean time to union was 24.5 weeks (12-37). Comparison to patients with unilateral injuries revealed a higher ISS, resuscitation requirements, ARDS, hospital stay and mortality.