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[The functional treatment of diaphyseal femoral fractures].

Severely comminuted and wide open fractures of the femoral shaft, with or without condylar involvement, have always been very difficult to deal with order to assess the quantitative. Over a period of ten years, 35 "problem" fractures, selected from a series of 129 femoral shaft fractures, were managed by "functional treatment" with the aim of avoiding the risks inherent to osteosynthesis and achieving rapid healing while maintaining, from the very beginning, full function of the injured limb. The most frequent fractures in this series were severely comminuted and open fractures. All fractures healed within a mean time of 12.5 weeks. The results, evaluated according to the score table of the Functional Treatment Study Group, were as follows: excellent in 32 cases, good in 2 cases, and poor in one case (refracture). Functional treatment of "problem" femoral shaft fractures has proven to be reliable in light of the good results, despite the fact that the technique employed for this particular bone and type of fracture requires great care and expertise as well as careful patient selection.