@article {5292,
	title = {Use of femoral shaft fracture classification for predicting the risk of associated injuries.},
	journal = {J Orthop Trauma},
	volume = {25},
	year = {2011},
	month = {2011 Sep},
	pages = {556-9},
	abstract = {OBJECTIVES: To investigate the hypothesis that specific fracture patterns in patients with femoral shaft fractures can predict the likelihood of associated injuries.

DESIGN: Retrospective cohort study.

SETTING: Level I trauma center.

PATIENTS/PARTICIPANTS: Consecutive patients treated because of a traumatic diaphyseal femoral fracture.

MAIN OUTCOME MEASUREMENT: We studied the association between the Orthopaedic Trauma Association (OTA) fracture classification (derived from initial radiographs) and concomitant injuries of the head, spine, chest, abdomen, and pelvis with a severity of two or more points according to the Abbreviated Injury Scale by logistic regression analysis.

RESULTS: One hundred forty-three of 203 patients (80 men, 63 women; mean age 54 {\textpm} 26 years) met the inclusion criteria. All patients had unilateral diaphyseal fractures, 64 OTA 32.A (45\%), 46 OTA 32.B (32\%), and 33 OTA 32.C (23\%). In addition, 134 associated injuries were identified in 52 patients. Increasing fracture severity, as expressed by the OTA classification (ie, A, B, C), was significantly associated with a higher likelihood of thoracic (odds ratio [OR], 5.89; 95\% confidence interval [CI], 2.59-13.40), pelvic (OR, 4.55; 95\% CI, 2.01-10.28), upper (OR, 2.38; 95\% CI, 1.27-4.48), and lower extremity injuries (OR, 3.12; 95\% CI, 1.78-5.46). Fracture severity explained between 70\% and 86\% of the probability of having accompanying injuries.

CONCLUSION: Radiographic grading of the severity of a femoral shaft fracture may signal the presence of accompanying injuries and should contribute to the clinical decision-making process in severe trauma.},
	keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Cohort Studies, Female, Femoral Fractures, Humans, Male, Middle Aged, Multiple Trauma, Predictive Value of Tests, Radiography, Retrospective Studies, Risk Factors, Trauma Centers, Young Adult},
	issn = {1531-2291},
	doi = {10.1097/BOT.0b013e318206cd06},
	author = {Nikolaou, Vassilios S and Stengel, Dirk and Konings, Peter and Kontakis, George and Petridis, Gerasimos and Petrakakis, Giannos and Giannoudis, Peter V}
}
