In a study of the results of operative reduction and internal
stabilization of eighty-nine femoral fractures, operative reduction was
performed within six days in fifty-four of the fractures and between seven
and thirty days in thirty-five. Dual Eggers plates were used in sixty-three
fractures; intramedullary nails, in eighteen; a nail-plate, in six; and a
single plate, in two fractures. The criteria for ultimate healing were
roentgenographic demonstration of bridging callus and the ability of the
patient to bear full, unsupported weight on the extremity. Healing that
occurred later than nine months after fracture was considered to be
delayed. In the group treated by early operative management, the incidence
of delayed union was 18 per cent and of non-union, 18 per cent. In the
group treated by delayed operative management, the incidence of delayed
union was 3 per cent and there were no instances of non-union. All ten
non-unions, ten of the eleven delayed unions, and five of the six
infections occurred in the early operative group.