Closed Reduction and Early Cast-Brace Ambulation in the Treatment of Femoral Fractures

In 143 femoral fractures treated by closed reduction, early application of a cast-brace, and ambulation, the incidence of non-union and malunion was 0.7 per cent; of shortening of more than two centimeters, 13 per cent; of symptomatic loss of knee motion, 5.4 per cent; of refracture, 2 per cent; and of pulmonary emboli, 3 per cent. The method was found to be especially suited for the primary treatment of distal fractures, comminuted mid-shaft fractures, and open fractures, but was also useful for the management of infected, ununited fractures in conjunction with standard bone-grafting procedures. Transverse fractures in the mid-third and proximal-third could be managed successfully by this method provided the surgeon observed the alignment closely, maintaining the position of the fragments by ancillary procedures as needed.