THE EPIDEMIOLOGY OF FRACTURED FEMURS AND THE EFFECT OF THESE FACTORS ON OUTCOME

We have analysed 250 cases of fractured shaft of the femur with the ob jective of highlighting any preventative measures and anticipating mor bidity associated with cause and type of injury. The younger patients typically injure themselves as pedestrians, motorcyclists and bicyclis ts in Summer. The older patients tend to have falls in late Summer and Winter. The outcome varies depending on the cause, type and age of th e injured person. The greatest morbidity was found in high-velocity ac cidents involving motorcyclists, pedestrians and car accidents. Knee f lexion is a particular problem with these injuries and we are currentl y using continuous passive motion in conjunction with a continuous opi ate infusion where this is likely to be a problem. The results also su ggest that the mechanism of injury and its possible prevention, partic ularly in motorcycle design, could be as important as the type of trea tment. Elderly females following falls also form a distinct group, sug gesting that osteoporosis is a major factor with the best outcome asso ciated with treatment by internal fixation. We feel that age alone sho uld not be a reason for exclusion from intramedullary fixation and thi s merits further study.