Patterns, Management, and Outcome of Traumatic Femur Fracture: Exploring the Experience of the Only Level 1 Trauma Center in Qatar

Syed Imran Ghouri, Mohammad Asim, Fuad Mustafa, Ahad Kanbar, Mohamed Ellabib, Hisham Al Jogol, Mohammed Muneer, Nuri Abdurraheim, Atirek Pratap Goel, Husham Abdelrahman, Hassan Al-Thani and Ayman El-Menyar
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Syed Imran Ghouri: Department of Surgery, Orthopedic Surgery, Hamad General Hospital, Doha, Qatar
Mohammad Asim: Clinical Research, Trauma and Vascular Surgery, Hamad General Hospital, Doha, Qatar
Fuad Mustafa: Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar
Ahad Kanbar: Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar
Mohamed Ellabib: Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar
Hisham Al Jogol: Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar
Mohammed Muneer: Department of Surgery, Plastic Surgery, Hamad General Hospital, Doha, Qatar
Nuri Abdurraheim: Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar
Atirek Pratap Goel: Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar
Husham Abdelrahman: Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar
Hassan Al-Thani: Department of Surgery, Trauma and Vascular Surgery, Hamad General Hospital, Doha, Qatar
Ayman El-Menyar: Clinical Research, Trauma and Vascular Surgery, Hamad General Hospital, Doha, Qatar

IJERPH, 2021, vol. 18, issue 11, 1-13

Abstract: Background: Femur is the most fractured long bone in the body that often necessitates surgical fixation; however, data on the impact of the mechanism of injury (MOI), age, and timing of intervention are lacking in our region of the Arab Middle East. We aimed to describe the patterns, management, and outcome of traumatic femoral shaft fractures. Methods: A retrospective descriptive observational study was conducted for all trauma patients admitted with femoral shaft fractures between January 2012 and December 2015 at the only level 1 trauma center and tertiary hospital in the country. Data were analyzed and compared according to the time to intervention (intramedullary nailing; IMN), MOI, and age groups. Main outcomes included in-hospital complications and mortality. Results: A total of 605 hospitalized cases with femur fractures were reviewed. The mean age was 30.7 ± 16.2 years. The majority of fractures were unilateral (96.7%) and 91% were closed fractures. Three-fourths of fractures were treated by reamed intramedullary nailing (rIMN), antegrade in 80%. The pyriform fossa nails were used in 71.6% while trochanteric entry nails were used in 28.4%. Forty-five (8.9%) fractures were treated with an external fixator, 37 (6.1%) had conservative management. Traffic-related injuries occurred more in patients aged 14–30 years, whereas fall-related injuries were significantly higher in patients aged 31–59. Thirty-one patients (7.8%) had rIMN in less than 6 h post-injury, 106 (25.5%) had rIMN after 6–12 h and 267 (66.8%) had rIMN after more than 12 h. The implant type, duration of surgery, DVT prophylaxis, in-hospital complications, and mortality were comparable among the three treatment groups. Conclusions: In our center, the frequency of femoral fracture was 11%, and it mainly affected severely injured young males due to traffic-related collisions or falls. Further multicenter studies are needed to set a consensus for an appropriate management of femur fracture based on the MOI, location, and timing of injury.

Keywords: femur fracture; orthopedic; trauma; management and outcome; Qatar (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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