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Closed Reduction and Early Cast-Brace Ambulation in the Treatment of Femoral Fractures PART I: AN In Vivo QUANTITATIVE ANALYSIS OF IMMOBILIZATION IN SKELETAL TRACTION AND A CAST-BRACE
JOHN F. CONNOLLY; PAUL KING
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From the Departments of Orthopedic Surgery and Biomedical Engineering, School of Medicine, Vanderbilt University, and Veterans Administration Hospital, Nashville
1973 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1973; 55:1559-1580 
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Abstract

Measurements of axial rotation and translation of the fragments in thirty patients with fractures of the femoral shaft and condylar regions, using a specially designed electrogoniometer and cineroentgenography, were made while patients were in bed (in skeletal traction, in suspension without traction, and in a cast-brace), and while they walked in a cast-brace. Rotation in bed was less in the cast-brace than in traction or suspension, and with two exceptions was less walking in the cast-brace than in traction in bed. Translation during weight-bearing in the cast-brace was least with the supracondylar-intercondylar and mid-shaft comminuted fractures, and most with the mid-shaft transverse fractures. Based on these observations, we concluded that closed reduction and early ambulation in a cast-brace are best suited for fractures in the distal part of the femur and for comminuted multifragmented fractures in the middle and proximal part of the shaft.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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