Treatment of the Segmental Fractures of the Femoral Shaft by Intramedullary Nailing

Ahn, Jong Chul; Lee, Dong Dhul; Cho, Jin Chul

Abstract

Segmental fractures of the femoral shaft result from high energy trauma such as a traffic accident or falls, and it is frequently accompanied by multiple fractures and severe injuries to other organs. Thus it is very difficult to treat these fractures satisfactorily and several complications can be caused. Early operative intervention and rigid fixation is important to mobilize the patient and to ensure early rehabilitation. Nineteen cases of segmental fractures of the femoral shaft were treated with operative intervention(intramedullary nailing) and followed up between May 1989 and Nov. 1993.; minimal follow-up period was more than one year. Results were obtained as follows: 1. The methods of treatment were interlocking intramedullary nailing in 16 cases(colsed nailing in 7 cases, open nailing in 9 cases) and Kiintscher nailing in 3 cases. Bone grafts were done in 11 cases among 19 cases(8 cases in the interlocking nail group). 2. The closed interlocking intramedullary nailing could be obtained in more shortened operation time than in the open method. 3. There was earlier bone union time in the closed intramedullary nailing than in the open method with bone graft, but there was no statistical significance(SPSS/pc+progam). 4. There was a tendency of earlier bone union time in the proximal fracture site than in the distal fracture site.