One hundred and six patients with 108 femoral shaft fractures were
treated with a cast-brace. Ninety-eight cast-braces included an abdominal
band and hip hinge. At follow-up three femora showed coronal malalignment
that exceeded 9 degrees and sixty-nine showed varying degrees of sagittal
malalignment (thirty-eight having anterior bowing and thirty-one, posterior
bowing). Four patients regained only 100 degrees of knee flexion or less
and four others had hyperextension of the knee of more than 10 degrees.
Thirty-eight patients showed signs of knee instability but only four of
them had symptoms of instability. Four fractures were treated operatively
to correct excessive shortening or angulation and another fracture was
bone-grafted to promote union. The mean shortening was 10.9 millimeters
(standard deviation, 8.8 millimeters). Although the more comminuted of the
eighty-five middle-third fractures shortened more than the others, the
results of this method of treatment for these comminuted fractures were
acceptable.