title: Simultaneous bilateral femoral fractures: systemic complications in 14 cases.
abstract: We have retrospectively reviewed 14 patients with bilateral femoral shaft fractures who attended our institution between January 1993 and March 1999. The mean age of the patients was 38 years (19-75) and the median injury severity score (ISS) was 16 (interquartile range 10-20). Thirteen patients were treated with intramedullary nailing and 1 with plating and nailing within 24 h of admission to hospital. The mean resuscitation requirements were 10.6 (6-16) litres of colloid and crystalloid and 8.6 (4-30) units of blood. The mean intensive care unit/high dependency unit (ICU/HDU) stay was 4 days (1-14) and the mean hospital stay was 36.3 days (3-210). There were 6 cases of adult respiratory distress syndrome (ARDS), 1 compartment syndrome, 1 case of osteomyelitis, 1 above-knee amputation and 2 deaths (14.2%). The mean time to union was 24.5 weeks (12-37). Comparison to patients with unilateral injuries revealed a higher ISS, resuscitation requirements, ARDS, hospital stay and mortality.
authors.affiliation: Department of Trauma and Orthopaedics, St James's University, St James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
authors.forename: P V
authors.initials: PV
authors.lastname: Giannoudis
authors.forename: A
authors.initials: A
authors.lastname: Cohen
authors.forename: A
authors.initials: A
authors.lastname: Hinsche
authors.forename: T
authors.initials: T
authors.lastname: Stratford
authors.forename: S J
authors.initials: SJ
authors.lastname: Matthews
authors.forename: R M
authors.initials: RM
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012128:Respiratory Distress Syndrome / Q000209:etiology; D012189:Retrospective Studies