The treatment of femoral fractures by cast-brace application and early ambulation. A prospective review of one hundred and six patients.

One hundred and six patients with 108 femoral shaft fractures were treated with a cast-brace. Ninety-eight cast-braces included an abdominal band and hip hinge. At follow-up three femora showed coronal malalignment that exceeded 9 degrees and sixty-nine showed varying degrees of sagittal malalignment (thirty-eight having anterior bowing and thirty-one, posterior bowing). Four patients regained only 100 degrees of knee flexion or less and four others had hyperextension of the knee of more than 10 degrees. Thirty-eight patients showed signs of knee instability but only four of them had symptoms of instability. Four fractures were treated operatively to correct excessive shortening or angulation and another fracture was bone-grafted to promote union. The mean shortening was 10.9 millimeters (standard deviation, 8.8 millimeters). Although the more comminuted of the eighty-five middle-third fractures shortened more than the others, the results of this method of treatment for these comminuted fractures were acceptable.