Treatment of Fracture of the Femoral Shaft with the Brooker - Wills Distal Locking Intramedullary Nail in Adulthood

Choi, Ki Hong; Kang, Chung Nam; Wang, Jin Man; Roh, Kwon Jae; Lee, Sang Kyum

Abstract

The intramedullary nailing is the effective device now available for patient with appropriate fracture of the femoral shaft in adulthood. But problems with shortening and rotation of the femur persist, especially in comminuted fracture of the femoral shaft. So, the fixation with proximal and distal screw was performed. The Brooker-Wills nail achieves distal fixation easily with a transverse fixator deployed through slot in the nail. 24 patients with 25 femoral shaft fractures who treated at Dept. of Orthopaedic Surgery, Ewha Womans University Hospital from April, 1987 to April, 1988 were clinically analysed and the results were as follow. l. Among 25 cases, 22 cases were male and 3 cases were female. Average ages were 35.3 years and 3rd decade was more prominent. 2. 25 cases were classified according to the Winquist-Hansen classification. The Grade II was most common in 20 cases(80%). 3. 18 cases were treated by closed method and 7 cases were treated by open method. The closed method was required for 1.8 hours and open method was required for 2.2 hours. 4. The average time of union of Grade II was most shortened(11 weeks) and Grade IV was most delayed(16 weeks). 5. The complications were non-union in 1 case, mild angulation in 3 cases and limitation of motion of knee joint in 2 cases. So the accurate anatomical reduction and nailing to just above the epiphyseal scar in the metaphysis will be decreased of any complications.