The knee after midshaft femoral fracture treatment: a comparison of three methods.

A retrospective study of knee function has been carried out in 85 patients who had fractures of the midshaft of the femur treated by three currently used methods. Patients who had undergone open medullary fixation, skeletal traction with early knee movements, and skeletal traction with an immobile knee have been compared. All the patients were reviewed personally, with a mean follow-up time of 5 years. We found that 30 per cent of all the patients had minor knee symptoms, and nearly half (45 per cent) had some ligamentous laxity. When bony union resulted, there was no difference in the effect on knee function between the three methods of treatment. Neither skeletal traction nor early knee movement had a harmful effect on the knee in the absence of any major ligamentous injury.