Femoral shaft fractures associated with unstable pelvic fractures.

From December 1986 to December 1989, 23 consecutive adult patients with femoral shaft fractures associated with unstable pelvic fractures were prospectively studied. The mortality rate was 8.7%. An anterior frame of an external fixator was sometimes inserted emergently in patients with multiple injuries to improve their bedside care. Early reamed femoral intramedullary nailing accompanying closed or open reduction with internal fixation, external fixation or both for unstable pelvic fractures was the favored treatment method. Twenty cases were followed for an average of 26 months. The union rate was high (95%) and the complication rate was low (5%). Hip and knee joint function was also satisfactory. Combined femoral shaft and unstable pelvic fractures are severe injuries and necessitate aggressive emergent management. With the techniques described, patients can achieve optimal outcome.