Simultaneous bilateral femoral shaft fractures.

Simultaneous bilateral femoral shaft fractures are unusual injuries caused by severe force and are usually associated with multiple injuries. There are few reports in the literature. From December 1986 to April 1989, there were 21 consecutive adult (greater than 16 years old) bilateral femoral shaft fracture cases treated at our hospital. The incidence was 2.0% (21/1,065). The associated multiple injuries (42 sites; 2.0 sites per case) markedly influenced the prognosis. There were two deaths, one bilateral above-knee amputation, and 15 cases followed for at least 1 year (average, 25 months). The individual fracture union rate was 80.0% (24/30) and the union period, 5.1 +/- 1.7 months. Complications (26.7%, 8/30) included nonunion, 20.0% (6/30); chronic osteomyelitis, 3.3% (1/30); and, limb shortening, 3.3% (1/30). All complications were in the open method treatment group: 40.0% (8/20) (p less than 0.05). We conclude that bilateral femoral shaft fractures indicate severe systemic and local injuries necessitating aggressive management, and the femoral shaft fracture itself should be treated with a closed nailing technique.