CHAPTER XIII - FRACTURES OF THE SHAFT OF THE FEMUR

Summary

The treatment of fractures of the shaft of the femur is of particular interest, demonstrating as it does certain fundamental fracture mechanics previously described in more general terms. It seems probable that new operative methods of treating the fractured femur—such as the medullary nail of Kuntscher—will in the future take precedence over closed methods for transverse fractures of the shaft (which are always difficult to handle by conservative means) and for most other fractures in the middle and upper thirds. For fractures of the femur in the distal third which have been successfully reduced I believe that Thomas5 method is unrivalled.

One of the many lessons we can learn from this fracture is the danger of becoming too much engrossed in minutiae, if by so doing we lose the broad view of a problem. This is an error into which the tempo of modern life makes it easy to fall. We must never lose sight of two facts: firstly, that a fracture of the shaft of a femur can often be the easiest of fractures to treat conservatively; and secondly, that full recovery after a fracture of the femur takes about one year (which is the time necessary for full reconstruction of the ivory shaft of this bone). These are facts which we tend to forget when assessing new methods which apparently offer quick dividends and short hospitalisation. Procedures adopted in the early phases of treatment can sometimes have disappointing and unexpected repercussions at a later date.