Femoral Diaphyseal Fractures in Adults: Pattern of Presentation and Outcome

Abstract

Background: Fractures of the femoral shaft are among the common fractures seen by orthopaedic surgeons. The relative distribution of these fractures depends on multiple factors including the geographic location (urban vs. rural) and country of study. The aim of this paper is to re-evaluate the aetiology, severity and mechanisms of injuries responsible for femoral fractures.
Study design: A prospective review of patients presenting at the Accident and Emergency (A/E) Department of the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife between February 2011 and January 2012 was carried out.
Results: Fifty-six femoral diaphyseal fractures in fifty-five patients with a mean age of 37.4±15.9years were seen. The male to female ratio was 1.7:1. The causes of injury were motor vehicular accidents (39.3%), motorcycle accidents (37.3%), pedestrian injuries (16.1%), fall from height (3.6%), gunshot injury (1.8%) and falling timber (1.8%). All were managed operatively with interlocking intramedullary nailing. Mean time to union was 16.4 ± 4.8 weeks and the complications included missed distal screws, delayed union, superficial and deep wound infection.
Conclusions: Motor vehicular and motorcycle crashes still remain the top causative factors of femoral diaphyseal fractures. More intense efforts should be directed towards reducing the menace of road accidents and provision of affordable health care for victims.

Key words: Femur, fractures, vehicular crashes, interlocking nail