Comparison of three treatments for fractures of the diaphysis of the femur.

Sixty-eight patients with fractured femurs were studied who, in terms of personal characteristics, associated injuries and type of fracture, could have been treated by intramedullary nailing or traction followed by the application of either a spica cast or fracture brace. Twenty-eight patients actually underwent intramedullary nailing, while 18 were treated with a spica cast and 22 with a fracture brace. Multiple outcome factors were studied and, based upon every comparison, intramedullary nailing was found superior. Among those patients treated by non-operative techniques, fracture bracing permitted earlier independent ambulation and increased the probability of normal knee motion at the conclusion of treatment.