Simultaneous bilateral femoral fractures: systemic complications in 14 cases

We have retrospectively reviewed 14 patients with bilateral femoral shaft f ractures who attended our institution between January 1993 and March 1999. The mean age of the patients was 38 years (19-75) and the median injury sev erity score (ISS) was 16 (interquartile range 10-20), Thirteen patients wer e treated with intramedullary nailing and 1 with plating and nailing within 24 h of admission to hospital. The mean resuscitation requirements were 10 .6 (6-16) litres of colloid and crystalloid and 8.6 (3-30) units of blood. The mean intensive care unit/high dependency unit (ICU/HDU) stay was 4 days (1-14) and the mean hospital stay was 36.3 days (3-210), Then were 6 cases of adult respiratory distress syndrome (ARDS), 1 compartment syndrome, 1 c ase of osteomyelitis, 1 above-knee amputation and 2 deaths (14.2%). The mea n time to union was 24.5 weeks (12-37), Comparison to patients with unilate ral injuries revealed a higher ISS, resuscitation requirements, ARDS, hospi tal stay and mortality.