Severity of injuries associated with femoral fractures as a result of motor vehicle collisions

Introduction: Femoral fractures are often the result of high-velocity injuries, and the early identification of associated injuries is important. The purpose of this study was to review the associated injuries present in a current UK series of patients who sustain femoral fractures as a result of motor vehicle accidents. Materials and methods: All cases of femoral fractures were extracted from the UK co-operative crash injury study (CCIS) database, from 1998 to 2002. Associated injuries, skeletal and non-skeletal, were identified by body region and severity (according to the abbreviated injury scale and injury severity scale). Results: A total of 5,841 crashes were investigated in that time period, and there were 365 car occupants who sustained a femoral fracture. The 16–35 age group accounted for nearly half of all cases. A total of 313 patients (85.2%) had at least one other concomitant significant injury, of which 84 (23.0%) had skeletal injury only, 45 (12.3%) had non-skeletal injury only, and 184 (50.4%) had both. The opposite lower limb was the most common skeletal injury, and thoracic injuries were the most common visceral injuries. Thoracic injuries also accounted for the most serious injuries (AIS 4–6). The overall mortality was 40.5% in our series. Conclusion: Concomitant injuries are to be expected in the majority of cases of femoral fractures sustained as a result of MVCs. There should be a low threshold for involving a general surgical team in the management of these cases.