The thigh-lacer: ambulatory non-operative treatment of femoral shaft fractures.
Thirty patients with fractures of the femoral shaft were treated by closed reduction, tibial-pin traction for three to six weeks, and early ambulation with crutches in a plastic thigh-lacer. Extensive quadriceps-strengthening exercises were performed. When the patient achieved active extension of the knee against gravity, weight-bearing as tolerated was encouraged. All of the fractures united. Follow-up ranged from eight to forty months. Malunion (angulation greater than 10 degrees) occurred in three patients and there was some loss of knee motion (less than 90 degrees of flexion) in one patient. Infection, refracture, non-union, and shortening of greater than two centimeters were not seen. This method of treatment yielded results comparable to those obtained with cast-bracing, without the high incidence of loss of knee motion, angulation, and prolonged cast treatment associated with that form of treatment.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004434:Early Ambulation; D005260:Female; D005264:Femoral Fractures / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D009068:Movement; D013165:Splints