Biomaterial Database

Treatment of femoral fractures in the multiply injured patient with thoracic injury. 1998

L B Bone, and M J Anders, and B J Rohrbacher

Department of Orthopaedic Surgery, State University of New York at Buffalo, Erie Country Medical Center 14215, USA.

Early fracture fixation in the multiply injured patient has been shown to reduce morbidity and mortality. This premise recently has been questioned when the multiply injured patient has a pulmonary contusion, and also has a femoral fracture stabilized with a reamed intramedullary nail. This put into question whether early stabilization of femoral fractures, especially with a reamed intramedullary nail, should be performed in patients with a pulmonary contusion. A review of the most recent clinical and animal research was performed to help answer this question. This review has revealed that the incidence of pulmonary failure and adult respiratory distress syndrome in multiply injured patients with thoracic injuries who have femoral fractures treated acutely is less than 3%. The morbidity associated with patients with pulmonary contusions is independent of the treatment of the femoral fracture. No difference in the rate of pulmonary failure is found with reamed nails or plate fixation. The pulmonary failure seems to be secondary to the pulmonary contusion, not to the method of fracture fixation.

UI	MeSH Term	Description	Entries
D008171	Lung Diseases	Pathological processes involving any part of the LUNG.	Pulmonary Diseases,Disease, Pulmonary,Diseases, Pulmonary,Pulmonary Disease,Disease, Lung,Diseases, Lung,Lung Disease
D009104	Multiple Trauma	Multiple physical insults or injuries occurring simultaneously.	Injuries, Multiple,Trauma, Multiple,Wounds, Multiple,Multiple Injuries,Polytrauma,Injury, Multiple,Multiple Injury,Multiple Traumas,Multiple Wound,Multiple Wounds,Polytraumas,Traumas, Multiple,Wound, Multiple
D012128	Respiratory Distress Syndrome	A syndrome characterized by progressive life-threatening RESPIRATORY INSUFFICIENCY in the absence of known LUNG DISEASES, usually following a systemic insult such as surgery or major TRAUMA.	ARDS, Human,Acute Respiratory Distress Syndrome,Adult Respiratory Distress Syndrome,Pediatric Respiratory Distress Syndrome,Respiratory Distress Syndrome, Acute,Respiratory Distress Syndrome, Adult,Respiratory Distress Syndrome, Pediatric,Shock Lung,Distress Syndrome, Respiratory,Distress Syndromes, Respiratory,Human ARDS,Lung, Shock,Respiratory Distress Syndromes,Syndrome, Respiratory Distress
D003288	Contusions	Injuries resulting in hemorrhage, usually manifested in the skin.	Bruise,Bruises,Contusion
D005264	Femoral Fractures	Fractures of the femur.	Femoral Fracture,Fracture, Femoral,Fractures, Femoral
D005594	Fracture Fixation, Intramedullary	The use of nails that are inserted into bone cavities in order to keep fractured bones together.	Intramedullary Nailing,Nailing, Intramedullary,Osteosynthesis, Fracture, Intramedullary,Fixation, Intramedullary Fracture,Fixations, Intramedullary Fracture,Fracture Fixations, Intramedullary,Intramedullary Fracture Fixation,Intramedullary Fracture Fixations,Intramedullary Nailings,Nailings, Intramedullary
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818	Animals	Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA.	Animal,Metazoa,Animalia
D013898	Thoracic Injuries	General or unspecified injuries to the chest area.	Chest Injuries,Injuries, Chest,Injuries, Thoracic,Chest Injury,Injury, Chest,Injury, Thoracic,Thoracic Injury