Surgical Discussion

Patient positioning:  The patient was positioned supine on the operating table to facilitate access to the lateral aspect of the thigh and allow for intraoperative fluoroscopic imaging.

Anatomical surgical approach:  A longitudinal lateral approach to the femur was performed. The incision extended along the lateral aspect of the thigh, allowing for subfascial dissection and exposure of the fracture site. The zone of injury was thoroughly debrided, including removal of any foreign material and devitalized tissue. The fracture was then stabilized using appropriate internal fixation.

The surgeon emphasized the importance of recognizing the high-energy nature of open femoral shaft fractures, regardless of the size of the skin wound. A formal exposure and debridement were deemed essential to prevent infection and ensure proper healing. The procedure adhered to the standard of care for such injuries, focusing on meticulous debridement and stabilization.

Postoperative protocol:   Postoperatively, the patient was placed on a rehabilitation protocol that included non-weight bearing on the affected limb initially, with gradual progression to partial weight bearing as tolerated. Range of motion exercises were initiated early to prevent joint stiffness.

Follow up:   Not specified.

Orthopaedic implants used:   Intramedullary nail for femoral shaft stabilization.