Treatment of proximal-third femur fractures with pins and thigh plaster

Thirty patients with proximal third femur fractures were treated with pins-in-thigh plaster. Patients were divided into two groups: (1) acute (pins-in-plaster applied within one month after injury); and (2) late (pins-in-plaster applied later than one month ater injury). Patients in the acute group had application of pins-in-plaster inserted at an average of nine days after injury, and were treated in plaster for 9.4 weeks with union occurring at 10.7 weeks. Patients in the late group had application of pins-in-plaster an average of 13.3 weeks after injury, treatment in plaster for 7.7 weeks, and union at 21 weeks. Subtrochanteric fractures healed as rapidly as other areas of the femur when braced early. Twenty-five fractures demonstrated less than 2 cm of shortening and less than 10 degrees of varus. There were no nonunions. One patient developed a deep wound infection. Antibiotics were required in seven patients because of pin tract drainage, which ceased once the pins were removed. This method is indicated in active patients with comminuted or open fractures but neither in the elderly or senile patients, or in intertrochanteric-subtrochanteric fractures.