Repairing Femur Fractures in Polytrauma Patients


Repairing Femur Fractures in Polytrauma Patients

I’m Ed Smith, a Sacramento Injury Lawyer. When patients are involved in an auto accident or a truck accident, there is a risk of suffering not just one bone fracture but many bone fractures. This is called polytrauma. If patients suffer a femur fracture as part of this type of accident, it can be a challenge to decide when to repair the injuries.

Early Repair or Later: The Risks and Rewards

The gut reaction for most people suffering a femur fracture is to repair it as quickly as possible; however, this isn’t always the best answer. Yes, patients are in pain and want to have their injuries repaired but patients suffering multiple traumatic injuries, such as traumatic brain injuries or spinal cord injuries along with their femur fracture, could be hemodynamically unstable. This means that their breathing, heart rate, and blood pressure are at risk of plummeting and the patient may not survive surgery. In patients fitting this description, when is the best time to repair their injuries?

The Study

A study was published in the Journal of Trauma and Acute Care Surgery that reviewed the care of patients with multiple injuries after a high-energy traumatic event. The study team conducted a review of the literature surrounding early versus late femur repair. The patients’ femur fractures were repaired using internal fixation with intermedullary nailing. They used software to review cases from multiple hospitals to look at the rates of complications and comorbidities following open reduction and internal fixation with regards to mortality, infection, and embolic events in trauma patients. The results of the study showed that earlier fixation showed a lower rate of complications, including those mentioned above; however, the difference in the results was not found to be statistically significant.

What Does it Mean?

While the rate of complications were lower yet not statistically significant, this means that the lower rate of complications could be due to chance; however, the study team still makes the recommendation that early femur fracture repair probably outweighs the risks. By using the word “probably,” the study team makes the recommendation that every case be handled on an individual case by case basis, an important point. Every patient’s set of injuries is different and should be discussed with the individual medical and surgical team. If the physicians state that it is better to wait for the patient to be stable to repair injuries, this is likely the right call. Surgery itself is a traumatic event and patients must be healthy enough to survive the repair. No fracture repair is worth the patient’s life.

Sacramento Bone Fracture & Personal Injury Lawyer

I’m Ed Smith, a Sacramento Injury Lawyer. Polytrauma is a serious matter and anyone suffering these injuries should reach out to me at (916) 921-6400 for friendly, free advice. My office maintains a toll-free line at (800) 404-5400.

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