Fractures of the femur a plea for conservative treatment

Many surgeons still report a high mortality rate in connection with fractures of the neck of the femur. Some years ago Lucas Championniere stated that more people die from immobilization than from injuries. The writer's personal experience with 36 cases of fracture of the neck of the femur, 55 cases of intertrochanteric fractures, 23 fractures of the shaft and 6 of the lower end of the femur, with only one death on the second day of admission to the hospital, even in the face of some criticism, 100 per cent of live patients, must endorse Championniere's statement as well as the treatment here outlined. Even the period of disability is markedly reduced. It must also be taken into consideration that 80 per cent of the patients ranged between sixty-five and ninety-three years of age, the remaining 20 per cent were between the ages of one and sixty-five. In a recent article by A. B. Gill⁴ the mortality rate is estimated at 25 per cent and increases rapidly beyond the age of sixty. He also states that non-union may be expected in 20 to 25 per cent in cases treated by the Whitman method or by open operation. In comparing the mortality rates and percentage of non-union quoted by Higgs, Gill and many others, the simple treatment, which may appear to some radical, or at least unorthodox, but which is in reality very conservative, as here outlined, prevents death and gives firm union of the fragments in 100 per cent of the cases.