Thoracic and lumbar fractures associated with femoral shaft fractures in the multiple trauma patient. Occult presentations and implications for femoral fracture stabilization.
Two-hundred-and-one patients with femoral shaft fractures were identified in a 5 year period at three institutions. Seven patients (3.5%) were found to have associated thoracic or lumbar fractures of various types. All resulted from high-velocity trauma. Four (57%) of these patients had thoracic or lumbar fractures that were undiagnosed on admission and before femoral fracture stabilization. A neurologic deficit persisted in four patients, and the possible contribution of femoral intramedullary rodding with positioning and traction must be considered. A high index of suspicion for thoracic and lumbar fractures is required when evaluating the high velocity trauma patient with a femoral shaft fracture. Presence of the thoracic or lumbar fracture may require initial spine stabilization or alter the method of femoral fracture treatment.
Rupp
R E
RE
Department of Orthopaedic Surgery, Medical College of Ohio, Toledo.
Ebraheim
N A
NA
Chrissos
M G
MG
Jackson
W T
WT
D000328:Adult; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000150:complications* / Q000601:surgery; D005594:Fracture Fixation, Intramedullary; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D009104:Multiple Trauma / Q000150:complications*; D011187:Posture; D016103:Spinal Fractures / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D013904:Thoracic Vertebrae / Q000293:injuries*; D013997:Time Factors