The Epidemiological and Clinical Features of Forensic Cases with Femur Fractures in the Emergency Department

INTRODUCTION: Femoral fractures represent high-morbidity and high-mortality injuries resulting from both low-energy trauma, particularly falls in older adults, and high-energy mechanisms such as traffic accidents and firearm injuries. This study aims to retrospectively analyze the demographic characteristics, trauma mechanisms, fracture localizations, and determinants of intensive care unit (ICU) admission among forensic cases presenting to the emergency department with femoral fractures.
METHODS: One hundred ninety-three forensic patients admitted with femoral fractures were reviewed retrospectively. Demographic data, trauma mechanisms, fracture sites, Glasgow Coma Scale (GCS) scores, and clinical course parameters were assessed. Multivariable logistic regression analysis was conducted to identify independent predictors of ICU admission.

RESULTS: Falls were the leading etiology, accounting for 82% of all cases, while traffic accidents and firearm injuries occurred less frequently. Proximal femoral fractures were the most common localization across all trauma types and were particularly predominant in low-energy injuries. Logistic regression analysis identified a GCS score ≤12 and high-energy trauma as the strongest independent predictors of ICU admission. Remarkably, age, sex, and comorbidities did not demonstrate independent associations with ICU requirement.
DISCUSSION AND CONCLUSION: The study findings highlight that trauma mechanism and neurological status are critical components of risk stratification in the emergency setting. They underscore the need for comprehensive medical and medico-legal evaluation of forensic femoral fracture cases, offering clinically relevant insights that may support decision-making in emergency care management.

Keywords: Femoral Fracture, Trauma Mechanism, Intensive Care Unit, Glasgow Coma Scale, Forensic Case.