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Patients with bilateral femoral fractures may have higher risk of complications, mortality
Recently published data demonstrated an increased risk for complications in patients with multiple long bone fractures, especially in the femur. Compared with patients with unilateral femoral fractures, those with multiple long bone fractures also had higher mortality and Injury Severity Scores.
Researchers retrospectively identified 1,249 unilateral femoral fractures treated between 2001 and 2011. Seventy-two patients (mean age: 41.5 years) had bilateral femur fractures with a mean Injury Severity Score (ISS) of 30. There were 19 open fractures out of a total of 144 fractured femurs.
Demographic characteristics, associated injuries, complications and mortality were determined after reviewing medical records. Additionally, the researchers determined treatment type and timing of surgery, noting any secondary procedures.
According to the researchers, two patients died within several post-injury before their fractures were treated. Thirteen of the 70 surviving patients had 21 other complications during their initial hospitalization; however, there was no occurrence of surgical wound infections.
The most common complication reported was deep venous thrombosis, which occurred in seven patients. Six patients were diagnosed with pneumonia, of whom five died; however, none of the patients had adult respiratory distress syndrome. Additionally, two patients died as a result of multiple organ failure, and all but one femoral fracture was healed primarily in the surviving patients.
There was no difference observed between the patients with complications and those without complications with regard to mean age, mean ISS and sex, even though complications were observed more in patients with chest injuries. Ten out of 13 patients with complications had chest injuries, compared with 16 patients without complications who had chest injuries.
No correlation was observed between timing of surgery and complication development, according to the researchers. Within 24 hours, 60 patients had definitive fixation of femur fractures, and two patients had provisional external fixation. Fifty-three patients without complications had stabilization within 24 hours, and five patients were treated on a delayed basis. Three patients with complications were treated on a delayed basis. ‒ by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.