Organ injuries associated with femoral fractures: Implications for severity or injury in motor vehicle collisions

Objective: To determine if motor vehicle collisions (MVCs) resulting in fem oral fractures were associated with a different injury severity and pattern of injury compared with crashes in which victims did not sustain femoral f ractures. Methods: Retrospective review of seriously injured motor vehicle occupants admitted to a regional trauma unit (Hamilton General Hospital) during a 69- month period (April 1991 to December 1996) for whom detailed crash details were known, Results: Data for 733 motor vehicle occupants with Injury Severity Scores g reater than 12 were available; 112 occupants (15.3%) sustained femoral frac tures, and 621 occupants (84.7%) did not sustain femoral fractures. Victims with femoral fractures had a significantly higher mean Injury Severity Sco re (29.4 compared with 25.3 for non-femoral fracture group; p < 0.001). The femoral fracture group had a higher incidence of bowel (p < 0.012) and hem opneumothorax (p < 0.02) injuries as well as an increased incidence of uppe r and lower extremity (p < 0.001) and pelvic (p < 0.05) fractures. Conclusion: The presence of a femoral fracture is strongly associated with the pattern and severity of injuries sustained by occupants in MVCs. A high index of suspicion is warranted in identifying associated organ injuries i n MVC victims with concomitant femoral fractures.