Evaluation of Single-Stage Bilateral Intramedullary Nail Fix
A Study was conducted to evaluate rates of complications in patients with bilateral femur fractures treated with intramedullary nailing (IMN) during either 1 single procedure or 2 separate procedures.

A multicenter retrospective review of patients sustaining bilateral femur fractures, treated with IMN in single or 2-stage procedure was done.

--A total of 246 patients were included, with 188 single-stage and 58 two-stage patients. Gender, age, injury severity score, abbreviated injury score, secondary injuries, Glasgow coma scale, and proportion of open fractures were similar between both groups.

--Acute respiratory distress syndrome (ARDS) occurred at higher rates in the 2-stage group.

--When further adjusted for age, gender, injury severity score, abbreviated injury score, Glasgow coma scale, and admission lactate, the single-stage group had a 78% reduced risk for ARDS.

--In-hospital mortality was higher in the single-stage cohort, although this did not meet statistical significance.

This study compares the outcomes of single-stage IMN fixation to two-stage IMN fixation for bilateral femoral shaft fractures. In polytrauma patients who are able to undergo simultaneous definitive fixation, single-stage bilateral femur IMN may reduce ARDS rates.

Source: https://journals.lww.com/jorthotrauma/Abstract/2021/09000/Single_Stage_Versus_2_Stage_Bilateral.10.aspx