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Use of femoral shaft fracture classification for predicting the risk of associated injuries.
MedLine Citation:
PMID:  21857424     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVES: : To investigate the hypothesis that specific fracture patterns in patients with femoral shaft fractures can predict the likelihood of associated injuries.
DESIGN: : Retrospective cohort study.
SETTING: : Level I trauma center.
PATIENTS/PARTICIPANTS: : Consecutive patients treated because of a traumatic diaphyseal femoral fracture.
MAIN OUTCOME MEASUREMENT: : We studied the association between the Orthopaedic Trauma Association (OTA) fracture classification (derived from initial radiographs) and concomitant injuries of the head, spine, chest, abdomen, and pelvis with a severity of two or more points according to the Abbreviated Injury Scale by logistic regression analysis.
RESULTS: : One hundred forty-three of 203 patients (80 men, 63 women; mean age 54 ± 26 years) met the inclusion criteria. All patients had unilateral diaphyseal fractures, 64 OTA 32.A (45%), 46 OTA 32.B (32%), and 33 OTA 32.C (23%). In addition, 134 associated injuries were identified in 52 patients. Increasing fracture severity, as expressed by the OTA classification (ie, A, B, C), was significantly associated with a higher likelihood of thoracic (odds ratio [OR], 5.89; 95% confidence interval [CI], 2.59-13.40), pelvic (OR, 4.55; 95% CI, 2.01-10.28), upper (OR, 2.38; 95% CI, 1.27-4.48), and lower extremity injuries (OR, 3.12; 95% CI, 1.78-5.46). Fracture severity explained between 70% and 86% of the probability of having accompanying injuries.
CONCLUSION: : Radiographic grading of the severity of a femoral shaft fracture may signal the presence of accompanying injuries and should contribute to the clinical decision-making process in severe trauma.
Authors:
Vassilios S Nikolaou; Dirk Stengel; Peter Konings; George Kontakis; Gerasimos Petridis; Giannos Petrakakis; Peter V Giannoudis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of orthopaedic trauma     Volume:  25     ISSN:  1531-2291     ISO Abbreviation:  J Orthop Trauma     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807705     Medline TA:  J Orthop Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  556-9     Citation Subset:  IM    
Affiliation:
From the *Academic Department of Trauma & Orthopaedics, School of Medicine, University of Leeds, Leeds, UK; †Center for Clinical Research, Department of Trauma and Orthopaedic Surgery, Unfallkrankenhaus Berlin and University of Greifswald, Greifswald, Germany; ‡Academic Department of Trauma & Orthopaedics, School of Medicine, University of Crete, Crete, Greece; and §School of Medicine, University of Crete, Crete, Greece.
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