Retrograde intramedullary nailing, without reaming, of fractures of the femoral shaft in multiply injured patients

Twenty consecutive multiply injured patients who had a total of twenty-two fractures of the femoral shaft were managed with intramedullary nailing without reaming. A retrograde technique through the intercondylar notch of the knee was used. All patients were followed for at least one year or until u...

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Bibliographic Details
Published in:Journal of bone and joint surgery. American volume 1995-10, Vol.77 (10), p.1520-1527
Main Authors: Moed, B R, Watson, J T
Format: Article
Language:English
Subjects:
Adult
Alloys
Biological and medical sciences
Bone Nails
Bone Screws
Female
Femoral Fractures - surgery
Follow-Up Studies
Fracture Fixation, Intramedullary - adverse effects
Fracture Fixation, Intramedullary - instrumentation
Fracture Fixation, Intramedullary - methods
Fracture Healing
Fractures, Malunited - etiology
Fractures, Ununited - etiology
Humans
Joint Dislocations - etiology
Knee - surgery
Knee Joint - physiopathology
Male
Medical sciences
Middle Aged
Multiple Trauma - surgery
Orthopedic surgery
Range of Motion, Articular
Rotation
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Time Factors
Titanium
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Summary:Twenty consecutive multiply injured patients who had a total of twenty-two fractures of the femoral shaft were managed with intramedullary nailing without reaming. A retrograde technique through the intercondylar notch of the knee was used. All patients were followed for at least one year or until union of the fracture. The operative time for the nailing averaged seventy-five minutes (range, thirty-five to 105 minutes). Union of the fracture occurred at an average of fifteen weeks. There were three non-unions and one rotational malunion. There were no infections, and no nail or screw failed. Normal motion of the knee was regained by all patients, except one who had had an ipsilateral dislocation of the knee. On the basis of these preliminary results, we concluded that retrograde nailing is a safe and effective technique for multiply injured patients. The apparently higher prevalence of non-union compared with that reported with antegrade nailing with reaming warrants additional study.
ISSN:0021-9355
1535-1386
DOI:10.2106/00004623-199510000-00006