Objective: Fractures of the shaft of the femur due to gun shot injuries represent
a challenging problem to the orthopedic surgeon. Lot of problems are
encountered during the management of such cases
Material: This study was done on 20 cases of fracture shaft femur collected
from El Salam Hospital, Sadah, Yemen republic, during the period of 2002 to
2004 to evaluate the results of biological plating of femoral fractures due to
gun shot injuries, there were 15 males and 5 females, follow up period ranged
from 18 to 36 months (average 20 months) age range from 18 to 65 (average 42
years), 4 cases were due to low velocity injury (hand guns) and 16 cases were
due to high velocity injury (automatic guns).
Methods: All cases were treated by biological plating using broad dynamic
compression plate either immediately or within 5 days of injury, 4 cases needed
supplementary iliac bone grafting to improve union, the clinical outcome was
assessed on clinical and radiological basis. Post operative range of motion
knee exercises started immediately and ambulation by 2 axillary crutches is
encouraged.
Results: 16 cases achieved union within 12 to 18 weeks and 4 cases showed
poor callus formation after 12 weeks and needed iliac bone grafting to
complete union which occurred within 8 to 12 weeks. Two cases (10%) showed
signs of superficial infection and two cases (10 %) showed mild varus deformity
less than 10 degrees.
Conclusion: For this short term follow up, biological plating of femoral shaft
fractures due to gunshot injuries proved to be an effective method of treating
femoral shaft fractures especially in areas with no facility for more recent techniques |