Management of femoral fractures in the burned extremity

Background The management of a fractured femur in the presence of an overlying burn involves consideration of the burn as well as the fracture. Physiologically and practically many of these patients are unsuitable for intramedullary nailing. Methods A retrospective review was carried out of patients admitted to the burns unit at Broomfield Hospital between 2001 and 2006 who had concomitant femoral shaft fractures. Results There were five femoral fractures in four patients with a mean age of 30.25 years. The mean total body surface area of burn was 65%. All of these fractures were managed with an external fixator, either in the emergency setting or as their definitive management. Satisfactory fracture union was achieved in the three surviving patients. Conclusions External fixation provides a practical and successful means of both emergent and definitive management of a femoral fracture in a patient with overlying burns.