A prospective randomized study comparing the results of early with
delayed reduction and stabilization of acute femoral fractures in adults
was performed over a two-year period in 178 patients. Only patients who
were more than sixty-five years old and had a fracture of the hip were
excluded. Arterial blood gases, injury-severity score at the time of
admission, pulmonary function, days in the hospital, days in the
intensive-care unit, and hospital costs were recorded for all patients. The
patients were divided into two groups: those who had an isolated fracture
of the femur and those who had multiple injuries. When stabilization of the
fracture was delayed in the patients who had multiple injuries, the
incidence of pulmonary complications (adult respiratory-distress syndrome,
fat embolism, and pneumonia) was higher, the hospital stay was longer, and
the number of days in the intensive-care unit was increased. The cost of
hospital care showed a statistically significant increase for all patients
who had delayed treatment of the fracture compared with those who had early
stabilization.