Articles: femoral-fractures-complications.
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Knee ligament injuries associated with femoral shaft fractures can severely influence the functional results of treatment. In a follow-up of 59 operatively treated femoral shaft fractures 18.6% of the patients revealed ligamentous damages. In all cases one or both of the cruciate ligaments were injured. ⋯ While only 61.6% of the ligament injuries were primarily diagnosed, the testing of knee joint stability after osteosynthesis of a femoral fracture is essential. Furthermore arthroscopy should be performed if there is any hint of ligamentous damage. The ruptures of the anterior cruciate ligament and the ligamentous avulsion fractures can be successfully treated on by operative means.
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A retrospective study of 53 patients with isolated femur fractures was performed to evaluate blood loss and transfusion incidence. Patients with other long bone fractures, abdominal, chest, mediastinal, and vascular injuries were excluded. Twenty-one patients required transfusion during the initial hospitalization averaging 2.5 units PRBCs. ⋯ Fracture patterns, classified as high or low energy, were not found to correlate with pre- or intraoperative blood loss, incidence of transfusion, delay to surgery or duration of hospital stay. The estimated blood loss in the study group averaged 1,276 cc, stressing the significance of long bone fractures in trauma patients. Preoperative hemorrhage determined transfusion need in contrast to intraoperative blood loss.
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Arch Orthop Trauma Surg · Jan 1992
A simpler surgical technique to treat aseptic nonunion-associated femoral length discrepancy.
In a prospective study from December 1986 to August 1989, 17 consecutive patients with femoral shortening due to aseptic nonunion of femoral shaft fractures were treated with limitedly open Gross-Kempf locking nailing with a lengthening procedure. Patients were followed up for at least 1 year (average 25 months). There was a 88.2% union rate with an average union period of 5.2 months. ⋯ Complications (11.8%) were 5.9% implant failure and 5.9% nonunion which were not difficult to manage. No neurovascular complications were noted. We conclude that for 5 cm shortening or less in femoral aseptic nonunion, this treatment constitutes the simplest technique and can achieve a very satisfactory result.
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A case of ipsilateral fracture-dislocation of the hip, knee, and ankle is presented. The patient had no neurovascular compromise or postoperative complications. A review of the literature produced no previous reports of this combination of injuries.
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Arch Orthop Trauma Surg · Jan 1991
ReviewKnee ligament injuries combined with ipsilateral tibial and femoral diaphyseal fractures: the "floating knee".
The incidence of rupture of the knee ligaments was retrospectively studied in 47 patients with ipsilateral fractures of the femoral and tibial diaphyseal shaft. Fifteen patients proved to have an instability of the knee at the time of follow up. Disruption of the knee ligaments had not been recognised initially. ⋯ After stabilisation of both fractures in these cases, the knee ligaments had been repaired; at re-examination these patients had no complaints and their knees were perfectly stable. In view of the high incidence of missed cases, the possibility of disruption of the knee ligaments should be considered in all patients with fractures of both the femoral and tibial shaft. Meticulous examination of the knee at the time of injury is strongly advocated.