LOW INFECTION AND NON-UNION RATES IN POLYTRAUMA FEMORAL FRACTURES: A RETROSPECTIVE STUDY.

Area of Science:

• Orthopedic Surgery
• Trauma Management

Background:

• Femoral shaft fractures are significant injuries requiring effective treatment strategies.
• Staged management using external fixation followed by intramedullary nailing (DCO) is a common approach.

Purpose of the Study:

• To evaluate the complications and risks associated with the DCO strategy for treating femoral shaft fractures.
• To identify factors influencing outcomes in patients treated with DCO.

Main Methods:

• Retrospective analysis of 37 patients (40 fractures) treated with DCO.
• Data collected included fracture classifications (AO/OTA, Gustilo), injury severity scores (ISS, GCS), and treatment parameters (time to fixation/conversion, nail type, reaming).
• Complications such as mortality, deep infection, and non-union were meticulously tracked.

Main Results:

• The majority of fractures were AO/OTA type A (45%), with a significant proportion being open (40%).
• The DCO strategy demonstrated low rates of deep infection (5%) and non-union (2.5%).
• Lower Glasgow Coma Scores (GCS) and longer intensive care unit (ICU) stays were associated with the DCO approach.

Conclusions:

• The DCO strategy for femoral shaft fractures is associated with favorable outcomes regarding infection and non-union.
• While effective, the DCO approach may correlate with increased ICU utilization and neurological impairment severity.