respiratory complications after early versus late stabilization of femoral shaft fracture

background: respiratory problems are common after long bone fractures. the objective of the present investigation is to evaluate the effect of early fixation of femoral shaft fracture on the incidence of respiratory problems.   methods: the results of early and late stabilization of femoral shaft fractures were studied in 150 patients. the patients were divided into two groups according to the status of their fractures. group i (n=123) had single and group ii had multiple fractures including femoral fractures. the patients in each group were divided into two subgroups, depending on whether operated within 48 hours (early) or in a longer period (late) after injury. serial arterial blood gas and chest radiographs were obtained to assess the acute respiratory distress syndrome, fat embolism syndrome, and abnormal blood gas values.   results: among 123 patients in group i, 63 were operated early after trauma, and the incidence of respiratory complications was 3.3% in comparison with 23.7% in the group ii. whereas, in group ii, 14 patients were in early operated subgroup and 13 in late operated subgroup and the incidences of respiratory complication were 7.1% and 76.5% respectively. there was a significant difference in subclinical fat embolism between early and late operated subgroups in group ii.   conclusion: early fixation of femoral shaft fracture in patients with femoral fractures greatly reduces pulmonary complications. iran j med sci 2006; 31(4): 216-220.   keywords ● early fixation ● late fixation ● femoral shaft fracture ● fat embolism ● ards