Acta Ortopédica Brasileira (Jun 2024)

LOW INFECTION AND NON-UNION RATES IN POLYTRAUMA FEMORAL FRACTURES: A RETROSPECTIVE STUDY

  • Matheus Trindade Bruxelas de Freitas,
  • Gabriel Benevides Valiate Martins,
  • Matheus Augusto Maciel Santiago,
  • Isaac Rocha Silva,
  • Marcos de Camargo Leonhardt,
  • Jorge dos Santos Silva,
  • Kodi Edson Kojima

DOI
https://doi.org/10.1590/1413-785220243202e278586
Journal volume & issue
Vol. 32, no. 2

Abstract

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ABSTRACT Objective: Assess complications and risks in staged femoral shaft fracture treatment using external fixation and intramedullary nailing (DCO). Methods: Analysis involved 37 patients with 40 fractures, mostly male (87.5%), average age 32.9 years. Data included ASA score, AO/OTA and Gustilo classifications, Glasgow Coma Score, Injury Severity Score, times to external fixation and conversion, ICU duration, nail type, and reaming status. Complications tracked were mortality, deep infection, and non-union. Results: Predominant fracture type was AO/OTA A (45%), with 40% open (Gustilo A, 93.8%). Average ISS was 21; GCS was 12.7. Median ICU stay was 3 days; average time to conversion was 10.2 days. Retrograde nails were used in 50% of cases, with reaming in 67.5%. Complications included deep infections in 5% and non-union in 2.5%. Conclusion: DCO strategy resulted in low infection and non-union rates, associated with lower GCS and longer ICU stays. Level of Evidence III; Retrospective Cohort Study.

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