Length unstable femoral fractures: A misnomer?

Table 1 Length unstable femur fractures

	Length unstable with FIMN (n = 21)			Length unstable with locked IMN, SMP, or external fixator (n = 29)			P value
Patient characteristics	Average	Minimum	Maximum	Average	Minimum	Maximum
Sex							0.19
Male	17			27
Female	4			2
Age, yr	7.41	5.2	11.9	9.31	5.8	12.4	0.004
Weight, kg	27.81	10.6	56.7	35.11	18	68	0.033
Fracture type							0.29
Spiral or oblique	16			18
Comminuted	5			11
Blood loss, mL	29.21	5	100	981	10	500	0.0036
Follow-up duration, mo	10.6	2	51.5	8	1	16	0.37
Time to weightbearing, d	39	23	60	36	12	63	0.45
Complications	Number (%)			Number (%)
Malunion	0			1 (3.4%)
Shortening	0			0
Arthrofibrosis	0			2 (6.9%)
Symptomatic	8 (38%)			3 (10.3%)
Hardware	0			1 (3.4%)
Changing treatment	1 (4.8%)			3 (10.3%)
Wound complications	0			0
Decreased ROM
Total	9 (42.8%)			10 (34.5%)			0.55
Minor	9 (100%)			4 (40%)			0.021
Major	0 (0%)			6 (60%)			0.026

¹Denotes statistical significance (P < 0.05). FIMN: Flexible intramedullary nailing; IMN: Intramedullary nailing; ROM: Range of motion; SMP: Submuscular plate.

Table 2 Femur fractures treated with flexible intramedullary nailing

	Length unstable fractures (n = 21)			Length stable fractures (n = 45)			P value
Patient characteristics	Average	Minimum	Maximum	Average	Minimum	Maximum
Sex							0.24
Male	17			28
Female	4			14
Age, yr	7.4	5.2	11.9	8.5	4.6	12.8	0.062
Weight, kg	27.8	10.6	56.7	32.1	16	58.5	0.144
Blood loss, mL	29.2	5	100	33.9	5	200	0.57
Follow-up duration, mo	10.6	2	51.5	6.8	1	24	0.204
Time to weightbearing, d	391	23	60	291	12	47	0.001
Complications	Number (%)			Number (%)
Malunion	0			0
Shortening	0			0
Arthrofibrosis	0			0
Symptomatic hardware	8 (38%)			15 (33.3%)
Changing treatment	0			2 (4.4%)
Wound complications	1 (4.8%)			1 (2.2%)
Decreased ROM	0			2 (4.4%)
Total	9 (42.8%)			20 (44.4%)			0.805
Minor	9 (100%)			16 (80%)			> 0.15
Major	0 (0%)			4 (20%)			> 0.15

¹denotes statistical significance (P < 0.05). FIMN: Flexible intramedullary nailing; IMN: Intramedullary nailing; ROM: Range of motion; SMP: Submuscular plate.