Segmental Femoral Shaft Fracture: is a Particular Injury?

Abstract

Original Research Article Introduction: Segmental fractures remain complex and particular injury. They result from high-energy trauma and are associated with a high rate of pseudoarthrosis. The aim of this work is to explain the difficulties of treating segmental femoral shaft fractures and to analyse the results of surgical treatment by intramedullary nailing (IMN). Patients and Methods: We studied a retrospective series of 20 cases of segmental femoral fractures over a seven-year period (20132019), treated with IMN and reviewed with an average of 30 months follow-up. Results: 20 patients presenting a segmental femoral fracture type 32-C2 according to AO. The average age of our patients was 33 years. 16 cases were victims of traffic accidents, we deplored in postoperative period one case of sural thrombophlebitis with good evolution. We had 80% union, in an average period of 30 weeks. Consolidation was more prolonged at the proximal focus than at the distal focus. We had four cases of aseptic pseudoarthrosis in the femur, successfully resumed by nailing and spongy grafting. Functionally, 15% of the cases presented a knee limitation and one of cases had rupture of ACL. Discussion: IMN proves to be the best means among the therapeutic arsenal in the surgical treatment of this particular entity but requires preoperative planning and technical requirements. Conclusion: This type of fracture must be considered as an entity apart from all diaphyseal fractures, both by the complexity of the fracture and the prolonged consolidation time. IMN, despite the difficulty of realization, remains a suitable therapeutic option.