Femoral shaft fractures: mechanisms, patterns and associated injuries in Makurdi, Nigeria

Context: The femur is the strongest and longest bone in the body but is frequently fractured in high energy trauma. Femoral shaft fractures are commonly associated with multiple system injury which may be missed during initial assessment. Methods: A four year retrospective   study was conducted at Benue State University Teaching Hospital. The data was ob¬tained from records of all the patients with femoral shaft fractures that were admitted and treated in the hospital. These included demographic characteristics, mechanism of fracture, associated injuries, radiological findings. and treatment options. Descriptive statistics done using the Statistical Package for Social Sciences version 16.0  (SPSS Inc. Chicago, IL).Results: There were 83 patients with femoral shaft fractures with  mean age of 32.75±1.5 years. The age range was 3 -80 years. There were 52 males and 21 females giving a  male to female ratio of  1.7:1 .Thirty of them (36.1%) presented  within 1 hour (Golden hour). There were 62(72.7%) closed fractures while open fractures accounted for 21(27.3%). The most common cause of femoral shaft  fracture was motor vehicular/motorcycle collision 28(33.7%).The most frequent fracture pattern observed was comminuted fracture accounting for 21(32.5%).There were 26 associated injuries occurring a total of 81 times in 52 patients.. Head injury accounted for 27(33.7%) of the associated injuries. Plate and screws, interlocking nail  and external fixation were used for treatment. Conclusion: Femoral shaft fractures are common and mostly result from  motor vehicular/motorcycle crashes among young people in Makurdi. These fractures are often associated with multiple system injuries including the head and limbs.