INTRAMEDULLARY FEMORAL OSTEOSYNTHESIS - AN ADDITIONAL CAUSE OF ARDS IN MULTIPLY INJURED PATIENTS

This study analysed the effects of reaming and intramedullary nailing and thoracic injury related to development of ARDS and multi-organ fai lure in multiply injured patients. Sixty patients were entered into a retrospective follow-up study. Twenty-one patients with thoracic injur y and femoral shaft fracture, treated by intramedullary nailing, were compared with 17 patients with a femoral shaft fracture without thorac ic injury, and with 22 patients without femoral shaft fracture but wit h major thoracic injury. The incidence of ARDS, multiple organ failure (MOF) and the mortality rate in the groups was analysed, using chi(2) and Fisher exact tests. No significant differences in age, sex and IS S existed between the groups. There were no statistically significant differences with regard to the incidence of developing ARDS (P>0.5), M OF (P>0.5) and mortality rate (P>0.2) after injury. The results of thi s study suggest that reaming of the femoral shaft as part of an intram edullary nailing procedure is not a major cause in developing ARDS and MOF in patients with femoral shaft fractures and thoracic injury. Con ventional intramedullary nailing can be considered as a safe procedure in femoral shaft fractures in multiply injured patients, as well as i n the presence of major thoracic injury. Copyright (C) 1996 Elsevier S cience Ltd.