Imran Sikandar Khan, Rizwan Hameed Malik.
Comparison of early and delayed internal fixation of the fracture shaft of femur at Pakistan Institute of Medical Sciences (P.I.M.S.).
Ann Pak Inst Med Sci Jan ;1(3):124-7.

Pakistan Institute of Medical Sciences (P.I.M.S.) orthopaedic/trauma department is faced with ever-increasing load of trauma patients. These include local trauma patients and referrals from other hospitals as well. Because of these reasons in most of the patients surgery is delayed for more than a week. This study was carried out to review the results of fracture healing if the operation is delayed for more than a week, compared to early fixation, i.e. within 6 days of fracture. Fractures fixed after the 8th week have not been included in this review. This review covers a period from January 1991 to January 1997. 86 patients with fracture shaft of femur were treated by internal fixation. The significant finding was that the patients who were treated early between 0-6 days had overall non-union rate of 26.6% whereas patients whose operations were delayed beyond 6 days i.e. after the 7th day had non-union rate of 0%. These figures correspond with those obtained in fractures of radius and ulna (Smith 1959) and those of femur (Charnley & Guindy 1961) and Eriksson. It has also been shown that early fixation of multiple fractures does reduce the incidence of fat embolism and respiratory distress syndrome.

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