Shortening and angulation of femoral shaft fractures treated by cast brace application and early ambulation.
Twenty-eight patients with femoral shaft fractures were treated by early three piece cast brace application and ambulation. Unacceptable femoral shortening occurred in the first week after cast brace application in seven cases. When bony union occurred, shortening did not exceed length lost from telescoping. Fracture alignment either remained unaltered or changed to varus in response to weight-bearing on the third or fourth day after cast brace application. Fractures aligned in either valgus or varus in excess of 5 degrees while the patient was lying prone tended to malalign further in that direction as healing progressed. If roentgenograms obtained in the week after cast brace application demonstrate unacceptable shortening, bed rest and skeletal traction should be instituted. With the patient lying prone, if roentgenograms show coronal malalignment greater than 5 degrees, that should be corrected by thigh cast wedging.
D000293:Adolescent; D000328:Adult; D002370:Casts, Surgical; D004434:Early Ambulation; D005264:Femoral Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007870:Leg Length Inequality / Q000209:etiology* / Q000517:prevention & control; D011859:Radiography