Strategies for the treatment of femoral fractures in severely injured patients: trends in over two decades from the TraumaRegister DGU(®).

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: RL declares that his institution receives an ongoing support from AUC, the data holder of TR-DGU, which includes statistical support of data analysis from registry data. 11. Orthop Traumatol Surg Res. 2021 May;107(3):102864. doi: 10.1016/j.otsr.2021.102864. Epub 2021 Feb 20. Bilateral femoral shaft fracture in polytrauma patients: Can intramedullary nailing be done on an emergency basis? Denis-Aubrée P(1), Dukan R(1), Karam K(1), Molina V(1), Court C(1), Bouthors C(2). Author information: (1)Hôpital Bicêtre, Le Kremlin-Bicêtre, France. (2)Hôpital Bicêtre, Le Kremlin-Bicêtre, France. Electronic address: charlie.bouthors@hotmail.fr. INTRODUCTION: Whether damage control orthopedics (DCO) or early total care (ETC) is the best way to treat polytrauma patients who have suffered a bilateral femoral shaft fracture remains unanswered. The aim of this study was to evaluate the morbidity of bilateral femur fractures treated by simultaneous intramedullary (IM) nailing according to ETC principles. MATERIALS AND METHODS: This retrospective single-centre study included all polytrauma patients who had suffered a femoral shaft fracture and were treated at our level I trauma centre. Demographic data, associated lesions, injury severity score (ISS) and occurrence of acute respiratory distress syndrome (ARDS) were collected prospectively in our trauma database. Unilateral fractures (UF) were compared to bilateral fractures (BF). The risk of ARDS was evaluated by multivariate logistic regression. RESULTS: Between 2010 and 2019, 176 UF (88%) and 25 BF (12%) were included. Patients with BF had a higher ISS (36 vs. 25, p