Duration of fracture healing after early versus delayed internal fixation of fractures of the femoral shaft

The effect of delayed internal fixation in closed uncomplicated fractures of the femoral shaft was studied by comparing 40 patients from a hospital where this fracture was principally treated within 24 hours of the injury, with 46 patients from another hospital where this type of fracture was principally treated after a mean period of 13 days in skeletal traction. The two groups of patients were similar with regard to age, level of fracture, type of fracture and incidence of comminution. All fractures were treated by stable internal fixation. In the group treated by early operation considerably longer AO plates were used. Although delayed fixation resulted in more callus and although secondary bone healing was more frequent than in the group with early internal fixation, no difference in the rate of union of the fractures could be demonstrated.