Femoral shaft fractures are a common orthopaedic injury. They are generally treated with intramedullary nailing. The optimal timing of operative treatment is variable and debated. Relatively simple femoral shaft fractures can be successfully treated in less than 24 hours in most health care systems. Femoral shaft fractures can be more complicated owing to various factors, such as multiple traumatic injuries, associated conditions, etc. These more complicated femoral shaft fractures benefit from stabilization within the first 6 hours to minimize complications. Stabilization of the long bones helps achieve an upright chest position and improves pulmonary, circulatory, and musculoskeletal function. Some patients with multiple severe traumatic injuries may suffer worsening of their general condition and pulmonary status. This article reviews concepts for selecting optimal timing of intramedullary fixation of femoral shaft fractures and reviews relevant current literature.
Crean, Trevor; William Curtis; and Thomas A. DeCoster. "Considerations in Surgical Timing for Femoral Shaft Fractures." Western Journal of Orthopaedics 10, 1 (2021). https://digitalrepository.unm.edu/wjo/vol10/iss1/3