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We studied retrospectively 14 patients who had been nailed and 12 patients who had been plated for femoral shaft fractures respectively 37 and 67 months previously. Isokinetic thigh muscle function measurements showed quadriceps strength to be fully restored in nailed patients, while there was a moderate persisting median deficit among plated patients. There was a similar moderate deficit in flexion strength for both groups. Strength restoration did not correlate with age at fracture or fracture level in the femur. It did, however, correlate strongly with the interval between fracture and study for flexion strength among nailed patients. It may be that this parameter also is eventually normalized in nailed patients.

Summary Twenty-six patients who had been operated for isolated femoral shaft fractures were studied. Fourteen had been treated with intramedullary nailing and 12 with AO plates. Only nailed patients were allowed early weight-bearing. Bone mineral density and muscle strength in knee extension and flexion were determined. There was a considerable loss of bone mineral in the distal femoral metaphysis and a moderate loss in the tibia. The mean loss was almost identical in the two groups. Muscle power in extension was better preserved in the nailed than in the plated patients. There was a significant correlation between loss of bone mineral and loss of muscle power.