Cast-bracing of femoral fractures: experience at emory university hospitals

At Emory University Hospitals from 1975 to 1979, 110 fractures of the femoral shaft were treated following a femoral fracture protocol with a single component cast-brace and early ambulation. In an effort to reduce the hospitalization and disability time in patients with mid-third and distal-third femoral fractures, a technique of modified Dehne bracing was used in which immediate ambulation was instituted after casting. Prior to initiation of this protocol, these fractures were routinely treated with six to eight weeks of balanced traction, followed by four to six months of cast fixation and a subsequent period of rehabilitation. Complications of the technique occurred in 9% of the patients, with shortening of 2.3 cm in 5%, refractures in 3% and malunion in 1%.This series of patients demonstrates the technical feasibility of a single component cast-brace and early ambulation for fractures of the femoral shaft, which is a great advance in the closed treatment of femoral fractures. Our results show that early cast-bracing using a modified Dehne technique is a viable method of treating fractures of the femoral shaft, with the technique being most effective when applied in the early stages- days one through 28. Indexing terms: cast-bracing, femoral fractures.