Efficient first aid, early reduction of the fracture, elevation of the fractured part, early mobilization of the extremity, early massage, and active motion will reduce the damage and prevent disability in fractures of the femur.
Any fracture that could have been reduced within the first week by direct skeletal traction can be reduced by this same traction, plus a minimum trauma open operation. In treatment of unreduced fractures, early reduction by tongs or nail combined with minimum trauma open operation is the method of choice.
By this method the newly formed callus is traumatized relatively little, and the danger of infection, delayed union, and non-union is minimized.
The combination treatment of direct skeletal traction, Hodgens splint, and Balkan frame, is as satisfactory in the treatment of old partially united unreduced fractures requiring open operation as it is in the acute fracture, and is the procedure of choice.