{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T19:02:30Z","timestamp":1783450950417,"version":"3.55.0"},"reference-count":31,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2017,8,7]],"date-time":"2017-08-07T00:00:00Z","timestamp":1502064000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background<\/ns4:bold>\n                    : Femoral shaft fractures, typical in younger people, are often associated with polytrauma followed by traumatic shock. In these situations, despite intramedullary nailing being the treatment of choice, external fixation could be used as the definitive treatment. The aim of this study is to report evidence regarding definitive treatment of femoral shaft fractures with monoaxial external fixation.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods<\/ns4:bold>\n                    : Between January 2006 and December 2015, 83 patients with 87 fractures were treated at the Department of Orthopaedics and Traumatology CTO of Turin, with a monoaxial external fixation device. Mean age at surgery, type of fracture, mean follow-up, time and modalities of treatment, non-weight bearing period, average healing, external fixation removal time, and complications were reported.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results<\/ns4:bold>\n                    : The average patient age was 31.43\u00b115.19 years. In 37 cases (42.53%) the right femur was involved. 73 (83.91%) fractures were closed, and 14 (16.09%) were open. The average follow-up time was 61.07\u00b121.86 weeks.\u00a0 In 68 (78.16%) fractures the fixation was carried out in the first 24 hours, using a monoaxial external fixator. In the remaining 19 cases, the average delay was 6.80\u00b14.54 days. Mean non-weight bearing time was 25.82\u00b127.66 days (ranging from 0 to 120). The 87 fractures united at an average of 23.60\u00b111.37 weeks (ranging from 13 to 102). The external fixator was removed after an average of 33.99\u00b114.33 weeks (ranging from 20 to 120). Reported complications included 9.19% of delayed union, 1.15% of septic non-union, 5.75% of malunion, and 8.05% cases of loss of reduction.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusions<\/ns4:bold>\n                    : External fixation of femoral shaft fractures in polytrauma is an ideal method for definitive fracture stabilization, with minimal additional operative trauma and an acceptable complication rate.\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.11893.1","type":"journal-article","created":{"date-parts":[[2017,8,7]],"date-time":"2017-08-07T04:40:17Z","timestamp":1502080817000},"page":"1333","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Treatment of femoral shaft fractures with monoaxial external fixation in polytrauma patients"],"prefix":"10.12688","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5246-9714","authenticated-orcid":false,"given":"Gianluca","family":"Testa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Aloj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Ghirri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eraclite","family":"Petruccelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Pavone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Mass\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2017,8,7]]},"reference":[{"key":"ref-1","doi-asserted-by":"crossref","first-page":"392-9","DOI":"10.1097\/00005373-199903000-00007","article-title":"Reamed intramedullary nailing of the femur: 551 cases.","volume":"46","author":"P Wolinsky","year":"1999","journal-title":"J Trauma."},{"key":"ref-2","first-page":"296-340","article-title":"Trauma-Management of Acutely Injured Patients.","author":"J Jurkovich","year":"1997"},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"e31","DOI":"10.2106\/JBJS.N.00314","article-title":"Estimating the global incidence of femoral fracture from road traffic collisions: a literature review.","volume":"97","author":"K Agarwal-Harding","year":"2015","journal-title":"J Bone Joint Surg Am."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"234-42","DOI":"10.1007\/s11684-012-0218-2","article-title":"Orthopaedic management in the polytrauma patient.","volume":"6","author":"J Halvorson","year":"2012","journal-title":"Front Med."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"529-39","DOI":"10.2106\/00004623-198466040-00006","article-title":"Closed intramedullary nailing of femoral fractures. A report of five hundred and twenty cases.","volume":"66","author":"R Winquist","year":"1984","journal-title":"J Bone Joint Surg Am."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"231-5","DOI":"10.1097\/TA.0b013e3181c488d8","article-title":"Closed intramedullary nailing of the femur in the lateral decubitus position.","volume":"68","author":"J Bishop","year":"2010","journal-title":"J Trauma."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"e4248","DOI":"10.1097\/MD.0000000000004248","article-title":"Reamed versus unreamed intramedullary nailing for the treatment of femoral fractures: A meta-analysis of prospective randomized controlled trials.","volume":"95","author":"A Li","year":"2016","journal-title":"Medicine (Baltimore)."},{"key":"ref-8","doi-asserted-by":"publisher","first-page":"25-38","DOI":"10.1007\/s00068-014-0448-x","article-title":"Intramedullary nailing after external fixation of the femur and tibia: a review of advantages and limits.","volume":"41","author":"P Pairon","year":"2015","journal-title":"Eur J Trauma Emerg Surg."},{"key":"ref-9","doi-asserted-by":"publisher","first-page":"602-605","DOI":"10.1097\/TA.0b013e3181aa21c0","article-title":"Safety and efficacy of damage control external fixation versus early definitive stabilization for femoral shaft fractures in the multiple-injured patient.","volume":"67","author":"M Tuttle","year":"2009","journal-title":"J Trauma."},{"key":"ref-10","first-page":"258-9","article-title":"Clinical and radiographic diagnosis of Watson-Jones\u2019 fractures and joint injuries","author":"L Kessel","year":"1992"},{"key":"ref-11","doi-asserted-by":"publisher","first-page":"409-13","DOI":"10.1007\/s00264-006-0187-7","article-title":"External fixation of complex femoral shaft fractures.","volume":"31","author":"M Zlowodzki","year":"2007","journal-title":"Int Orthop."},{"key":"ref-12","first-page":"858-84","article-title":"Delayed union and nonunion of fractures.","author":"J Taylor","year":"1992"},{"key":"ref-13","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s13063-016-1162-2","article-title":"Randomized, controlled, two-arm, interventional, multicenter study on risk-adapted damage control orthopedic surgery of femur shaft fractures in multiple-trauma patients.","volume":"17","author":"D Rixen","year":"2016","journal-title":"Trials."},{"key":"ref-14","doi-asserted-by":"publisher","first-page":"E77-80","DOI":"10.1097\/TA.0b013e3182159e0a","article-title":"Judet quadricepsplasty in the treatment of posttraumatic knee rigidity: long-term outcomes of 45 cases.","volume":"72","author":"V Oliveira","year":"2012","journal-title":"J Trauma Acute Care Surg."},{"key":"ref-15","first-page":"3-6","article-title":"Decreasing Complications of Quadricepsplasty for Knee Contracture after Femoral Fracture Treatment with an External Fixator: Report of Four Cases.","volume":"3","author":"M Noda","year":"2013","journal-title":"J Orthop Case Reports."},{"key":"ref-16","doi-asserted-by":"publisher","first-page":"633-640","DOI":"10.1097\/TA.0b013e3181cef471","article-title":"Skeletal traction versus external fixation in the initial temporization of femoral shaft fractures in severely injured patients.","volume":"68","author":"B Scannell","year":"2010","journal-title":"J Trauma."},{"key":"ref-17","first-page":"195-208","article-title":"The evolution of femoral shaft plating technique.","author":"S Rozbruch","year":"1998","journal-title":"Clin Orthop Relat Res."},{"key":"ref-18","doi-asserted-by":"publisher","first-page":"90-5","DOI":"10.4103\/1117-6806.188983","article-title":"Open Intramedullary Nailing for Segmental Long Bone Fractures: An Effective Alternative in a Resource-restricted Environment.","volume":"22","author":"O Babalola","year":"2016","journal-title":"Niger J Surg."},{"key":"ref-19","doi-asserted-by":"publisher","first-page":"497-502","DOI":"10.2298\/MPNS0810497S","article-title":"External skeletal fixation of femoral shaft fractures in polytrauma patients.","volume":"61","author":"P Stojiljkovi\u0107","year":"2008","journal-title":"Med Pregl."},{"key":"ref-20","first-page":"11-6","article-title":"Early versus delayed stabilization of femoral fractures: a prospective randomized study. 1989.","author":"L Bone","year":"2004","journal-title":"Clin Orthop Relat Res."},{"key":"ref-21","doi-asserted-by":"publisher","first-page":"312-8","DOI":"10.1097\/BOT.0000000000000528","article-title":"The Role of Elevated Lactate as a Risk Factor for Pulmonary Morbidity After Early Fixation of Femoral Shaft Fractures.","volume":"30","author":"J Richards","year":"2016","journal-title":"J Orthop Trauma."},{"key":"ref-22","first-page":"39-43","article-title":"External fixation of femoral fractures in multiply injured intensive care unit patients.","volume":"72","author":"K Kazakos","year":"2006","journal-title":"Acta Orthop Belg."},{"key":"ref-23","doi-asserted-by":"publisher","first-page":"221-5","DOI":"10.1016\/j.injury.2012.09.011","article-title":"Increased morbidity and mortality after bilateral femoral shaft fractures: myth or reality in the era of damage control?","volume":"44","author":"P Kobbe","year":"2013","journal-title":"Injury."},{"key":"ref-24","first-page":"218-23","article-title":"Principles of external fixation of the femur.","volume":"34","author":"S Sabharwal","year":"2005","journal-title":"Am J Orthop (Belle Mead NJ)."},{"key":"ref-25","first-page":"92-100","article-title":"Grading system for gunshot injuries to the femoral diaphysis in civilians.","author":"W Long","year":"2003","journal-title":"Clin Orthop Relat Res."},{"key":"ref-26","doi-asserted-by":"publisher","first-page":"360-4","DOI":"10.2106\/00004623-198466030-00007","article-title":"Fractures of the femoral shaft treated by external fixation with the Wagner device.","volume":"66","author":"E Dabezies","year":"1984","journal-title":"J Bone Joint Surg Am."},{"key":"ref-27","doi-asserted-by":"crossref","first-page":"S131-5","DOI":"10.5435\/00124635-200600001-00030","article-title":"External fixation versus conversion to intramedullary nailing for definitive management of closed fractures of the femoral and tibial shaft.","volume":"14","author":"G Della Rocca","year":"2006","journal-title":"J Am Acad Orthop Surg."},{"key":"ref-28","doi-asserted-by":"publisher","first-page":"499-507","DOI":"10.1016\/j.ocl.2013.06.004","article-title":"The evolution of damage control orthopedics: current evidence and practical applications of early appropriate care.","volume":"44","author":"J D'Alleyrand","year":"2013","journal-title":"Orthop Clin North Am."},{"key":"ref-29","first-page":"533-5","article-title":"External fixation in close comminuted femoral shaft fractures in adults.","volume":"14","author":"I Babar","year":"2004","journal-title":"J Coll Physicians Surg Pak."},{"key":"ref-30","doi-asserted-by":"publisher","first-page":"446-56","DOI":"10.1016\/S0035-1040(05)84362-4","article-title":"Single-plane external fixation of fresh fractures of the femur: critical analysis of 53 cases.","volume":"91","author":"P Bonnevialle","year":"2005","journal-title":"Rev Chir Orthop Repartrice Appar Mot."},{"key":"ref-31","doi-asserted-by":"publisher","DOI":"10.5256\/f1000research.11893.d170645","article-title":"Dataset 1 in: Definitive treatment of femoral shaft fractures with monoaxial external fixator in polytrauma.","author":"G Testa","year":"2017","journal-title":"F1000Research."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/6-1333\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/6-1333\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/6-1333\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2018,12,6]],"date-time":"2018-12-06T08:53:51Z","timestamp":1544086431000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/6-1333\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,7]]},"references-count":31,"URL":"https:\/\/doi.org\/10.12688\/f1000research.11893.1","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.12851.r24819","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.12851.r24820","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.12851.r24818","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.12851.r24818","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.12851.r24819","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.12851.r24820","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,7]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/6-1333\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.12851.r24819, Dario Pitino, Shoulder and Elbow Surgery Unit, Humanitas Research Hospital, Rozzano, Italy, 10 Aug 2017, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/6-1333\/v1#referee-response-24819","order":0,"name":"referee-response-24819","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.12851.r24818, Lorenza Marengo, Department of Pediatric Orthopedic and Traumatology, \"Cesare Arrigo\" Children\u2019s Hospital, Alessandria, Italy, 29 Aug 2017, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/6-1333\/v1#referee-response-24818","order":1,"name":"referee-response-24818","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.12851.r24820, Saverio Comitini, Dipartimento di Ortopedia e Traumatologia, Ospedale Maggiore, Bologna, Italy, 31 Aug 2017, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/6-1333\/v1#referee-response-24820","order":2,"name":"referee-response-24820","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Data associated with the article are available under the terms of the Creative Commons Zero \"No rights reserved\" data waiver (CC0 1.0 Public domain dedication).","order":0,"name":"copyright-info","label":"Copyright"}]}}