INFLUENCE OF PRIMARY PLATE OSTEOSYNTHESIS OF FEMUR FRACTURES ON COMPLICATIONS IN MULTIPLE TRAUMA PATIENTS WITH OR WITHOUT THORACIC INJURIES

Primary intramedullary nailing of femoral fractures is well known to i ncrease the risk of pulmonary complications, especially in multiple-tr auma patients with severe thoracic injuries. Aim of this study was to investigate the influence of primary plate ostesynthesis of femur frac tures on major complications after trauma. This retrospective study ba sed on the records of 325 multiple trauma patients (Injury severity sc ore ISS > 18, no letal brain injury, age 16-65). According to the abbr eviated injury scale of the Thorax (AIS T) patients were divided in gr oups without (AIS T < 3, ''N'') or with relevant thoracic injury (AIS T > = 3, ''T''). Both groups were additionally divided in subgroups wi thout severe trauma to the extremities (AIS E < 3, ''0'') or primary p late-osteosynthesis of femur fractures (< 24 h, ''1''). 4 groups were performed: NO (n = 39, ISS 25 +/- 1, pneumonia 10 %, ARDS 5 %, lethali ty 10 %); NI (n = 55, ISS 27 +/- 1, pneumonia 4 %, ARDS 5 %, lethality 4 %); TO (n = 137, ISS 28 +/- 1, pneumonia 21 %, ARDS 15 %, lethality 16 %); TI (n = 94, ISS 31 +/- 1, pneumonia 21 %, ARDS 17 %, lethality 15 %). Primary plate-osteosynthesis of femur fractures did not increa se lethality or incidence of pulmonary complications in patients with or without severe thoracic injuries. Also complication rate after prim ary plate-osteosynthesis was less compared to published results after intramedullary nailing. For this, primary plate-osteosynthesis is reco mmendable in case of multiple trauma with thoracic injuries.