Preliminary results of treatment of fractures of the femur by cast-bracing using the Zaria metal hinge

Abstract

This is a prospective study of 27 patients with fractures of the femur at different levels and treated by cast-bracing using the Zaria hinge. The shortest follow-up period is 6 months. The brace was applied after an average of 4.5 weeks in traction. No alignment jigs or other accessory appliances were used. The patients got up 1–3 days after application of the brace and left hospital 5.8 weeks after fracture. Healing of the fracture was judged clinically and radiologically. The patients were pleased with the method. The average time in the brace was 9 weeks and to clinical union was 13.5 weeks. Three patients had shortening of more than 2.5 cm and six fractures were bent by more than 10 degrees but most of these deformities were present before the brace was applied. When the brace was removed the average range of flexion at the knee was 0–80 degrees and 6 months after fracture it was virtually full. The only notable difficulty with the hinge was loosening of the proximal end-plate. It is concluded that the Zaria metal hinge is an effective device for the cast-bracing of fractures of the femur, that alignment jigs and other accessory appliances are not essential for its application and that the cast-brace method is particularly suitable for use in the developing countries because of its effectiveness, simplicity and cheapness.