Outcome of Delayed Minimally Invasive Plate Osteosynthesis in Firearm Injuries of Femoral Shaft

Objectives: To evaluate the results of bridge plating in comminuted femoral shaft fractures in adults due to high velocity firearm injuries. Study Design: A cross-sectional observational study. Patients & Subjects: A total of 30 Patients with fracture of femoral shaft from high velocity firearm injury were studied, who met the inclusion criteria. Methods: The patients were admitted through Emergency Department after completing the initial protocol. Multiple debridements were done if needed and subsequent fixation was done in 02 to 03 weeks of initial injury. Results: We achieved union in all the cases. The average time to union was 20 weeks and 6 days. Male to female ratio was 4:1. There were 02 cases (6.7%) of delayed union & 01 case (3.31%) of nonunion. Infection occurred in 04 pts (13.4%), 02(6.7%) with superficial and 02 (6.7%) with deep infection. Hardware pain was experienced by 03 patients (10%). Conclusion: The comminuted fracture of the femoral shaft due to high velocity firearm injuries can be managed with excellent results using the minimally invasive plate (biological) fixation. The key to success is debridement of devitalized tissue and hence eradication of infection before fixation.