Articles: femoral-fractures-complications.
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Arch Orthop Trauma Surg · Jan 1999
Case ReportsSciatic nerve injury associated with fracture of the femoral shaft.
The sciatic nerve escapes injury in most fractures of the femoral shaft. We report a case of sciatic nerve palsy associated with a fracture at the distal shaft of the femur. The common peroneal division of the sciatic nerve was lacerated by a bone fragment at the fracture site. Despite the delay in treatment, a satisfactory result was obtained.
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To confirm the need to check anteversion (AV) of the intact femur to prevent malrotation deformity following intramedullary nailing in femoral shaft fracture. ⋯ Because true neutral rotation of the distal fragment alone is not accurate in preventing malrotation deformity of the femur following intramedullary nailing, we recommend measuring AV in both intact and fractured femurs and correcting rotational malalignment if it exists at the time of femoral nailing. Rotational alignment did not change significantly unless we failed to externally reduce the fracture due to a flexion deformity of the proximal fragment.
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In a consecutive series of 274 patients with isolated femoral shaft fractures 11 patients (4%) developed fat embolism syndrome. There were no cases of fat embolism syndrome in patients over the age of 35 years. ⋯ This left 109 patients who had nailing performed more than 10 h after injury of whom eleven (10%) developed fat embolism syndrome (p < 0.027). Patients under the age of 35 years with isolated femoral fractures should have nailing performed as early as possible after injury to minimize fat embolism syndrome.
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Arch Orthop Trauma Surg · Jan 1998
Review Case ReportsAbscess formation as a complication caused by postoperative osteomyelitis of the femur.
We report an unusual case of a giant femoral abscess caused by postoperative osteomyelitis after treating a fracture of the femoral shaft. The patient ignored it until the abscess began to interfere with knee flexion, but no symptoms of inflammation such as fever, pain or abnormal laboratory values were found. Within the marrow cavity, many plasma cells produced immunoglobulins G and M, and the level of these substances in the abscess fluid connected to the bony focus were higher than the serum levels. It was concluded that the inflammation in this case signified a peculiarity in a primarily chronic process.
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The aim of this study was to determine (a) whether delay in femur fracture stabilization beyond twenty-four hours in patients with head injury increased the risk of pulmonary complications and (b) whether immediate (up to twenty-four hours) femur fracture stabilization increased the risk of central nervous system (CNS) complications. ⋯ Delay in stabilization of femur fracture in head-injured patients appears to increase the risk of pulmonary complications. However, due to selection bias in this patient sample, this question cannot be definitively answered. Early fracture stabilization did not increase the prevalence of CNS complications.