Abstract
Introduction and Aims: Open femoral fracture is a serious injury. We have asked the question: do open femur fractures in polytrauma patients correlate with higher injury severity scores, increased length of stay and higher mortality rates than in closed femur fracture polytrauma patients.
Method: We undertook a retrospective review of a prospectively gathered trauma database at a Level 1 trauma centre. We identified multiple-injured patients with femur fractures who presented in a 36 month period. The cases were divided into 2 groups; open femur fractures (n=33) and closed femur fractures (n=80). Data was collected on demographics, precipitating event, length of stay spent in the ICU, number of associated injuries, ISS, AIS for affected systems, number of femoral surgeries and disposition. Data was analyzed using parametric statistical tests with a significance level of 0.05.
Results: Our analysis revealed that an average, patients in the open femur fracture group spent 8 + 9 days in ICU, sustained 4 + 1 associated injuries, underwent 2 + 1 femoral surgeries, had an ISS of 29 + 13, and died of their injuries in 30.3% of cases. Patients in the closed femur fracture groups spent 8 + 9 days in ICU, sustained 4 + 1 associated injuries, underwent 1 + 1 femoral surgeries, had an ISS of 29 + 14, and died of their injuries in 12.5% of cases. One-way ANOVA showed no statistically significant difference between groups in terms of time spent in ICU, ISS and number of associated injuries. The average number of surgeries was significantly greater in the open femur fracture group (p-value 0.000). A Chi-squared analysis of disposition indicated that patients with femur fractures were more likely to die of their injuries (p-value 0.020).
Conclusions: Findings of the current study demonstrate that while the presence of an open femur fracture does not correlate with an increase in ISS or increase ICU length of stay it may act as a marker for more serious prognosis in polytrauma patients.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
