OTA 2012 Posters

Scientific Poster #5 Hip/Femur OTA-2012

The Incidence of Femoral Neck Fractures Associated With Floating Knee Injuries

Bret D. Beavers, MD1; Robert N. Reddix, Jr., MD1,2; Terry E. Rives, PhD, MPH1;
1John Peter Smith Hospital Orthopaedic Sugery Residency Program, Fort Worth, Texas, USA;
2University of North Texas Health Science Center, Fort Worth, Texas, USA;

Purpose: Our hypothesis was that patients with ipsilateral femoral shaft and tibia plateau/shaft fractures (floating knees) would have an increased incidence of femoral neck fractures, higher ISS, and longer hospital stays.

Methods: Utilizing our institution’s trauma registry, we identified patients from April 2002 to September 2010 with femoral shaft fractures. We retrospectively reviewed these patients’ medical records to identify mechanism of injury, Gustilo-Anderson grade for open injuries, fracture type and location, associated injuries, presence of a femoral neck fracture, fixation method, length of hospital stay, and the presence or absence of an ipsilateral tibia fracture.

Results: Our study group consisted of 458 femoral shaft fractures in 428 patients with an average age of 30 years (range, 13-89). Of these 458 femoral shaft fractures, we identified 66 patients with 71 extremities that had a fracture of the ipsilateral tibial plateau or shaft (group 1). Our internal control group, group 2, consisted of 387 isolated femoral shaft in 373 patients. There were 8 of 66 (12%) deaths in group 1 versus 9 of 373 (2.7%) in group 2. Femur fractures were treated with a retrograde approach in 68% of extremities in group 1 versus 46% in group 2. Femoral neck fractures were identified in 11 of 71 extremities (15.5%) in group 1 versus 27 of 387 extremities (7%) in group 2. There was a statistically significant difference between the two groups when comparing the incidence of femoral neck fractures. There was also a significant difference in ISS (26 vs 16) and hospital stays (21 vs 10 days) between the two groups.

Conclusion: We found an increased incidence of femoral neck fractures in floating knee injuries, as well as higher ISS and longer hospital stay. This highlights the high-energy nature of patients with this injury constellation.

• The FDA has not cleared this drug and/or medical device for the use described in this presentation   (i.e., the drug or medical device is being discussed for an “off label” use).  ◆FDA information not available at time of printing. Δ OTA Grant.