Closed Intramedullary Nailing of Femoral Shaft Fractures

Roh, Yak Woo; Lee, Tong Sun; Lee, Kwang Won

Abstract

Since May 1981, the standard method of treatment of the femoral shaft fractures at the Daejeon EuIji Deneral Hospital has been the closed intramedullary nailing technique of Kuntscher. We performed intramedullary nailing on thirty-five fractures of femoral shaft in 35 patients. Closed intramedullary nailing was used in twenty-eight femora and open intramedullary nailing with cerclage wiring in seven fractures, in which large butterfly fragment was present, precluding control of rotation or length, or both. The overall rate of union was 97 percent. The range of motion of the knee at follow up was good in 80%, fair in 14%, poor in 6% (Good Full extension; loss of flexion less than 10 degrees. Fair Any loss of extension;loss of flexion of 10 to 50 degrees, Poor Loss of more than 10 degrees of extension; range of flexion-extension less than 90 degrees). The advantages of this technique include the negligible risk of infection, the rapid stabilization of fracture, thus facilitating management of other associated injuries, the rapid return of function of the knee, and early union of fracture and return to work. It is authors' opinion that when proper equipment and expertise are available, than closed intramedullary nailing is the treatment of choice not only for simple uncomminuted fracture of the femoral shaft but also for open comminuted fractures.