Compression plating of acute femoral shaft fractures

Although intramedullary fixation has standardized the management of femoral shaft fractures, compression plating may offer a viable alternative. A retrospective review of acute femoral shaft fractures managed by open reduction and compression plating between 1980 and 1987 revealed 71 fractures in 69 patients. There were 58 closed fractures, and six grade I and seven grade II open fractures. All patients received prophylactic antibiotics. Sixty-nine percent of patients were bone grafted. Sixty-six of 71 fractures (93%) healed uneventfully. The average time until union was 16 weeks (range: 23 to 72). Complications included two nonunions, two refractures, and one broken implant (7%). Careful adherence to the principles of prophylactic antibiotics, medial cancellous bone grafting, and meticulous soft tissue technique can significantly reduce the complication rate of compression plating.