Elsevier

Injury

Volume 25, Issue 7, September 1994, Pages 419-422
Injury

Paper
Intramedullary nailing of open femoral shaft fractures

https://doi.org/10.1016/0020-1383(94)90264-XGet rights and content

Abstract

Twenty-seven patients with 28 open femoral shaft fractures were treated by intramedullary nailing. Ten fractures were Grade I, nine Grade II and nine Grade III according to Gustilo.

After debridement and irrigation of the wounds, 26 fractures were nailed immediately, whilst two fractures were stabilized at an early stage.

Two infections developed. One occurred before intramedullary nailing during a period of femoral traction. Both infections were treated successfully.

The authors conclude that primary intramedullary nailing is safe in open femoral fractures of all grades. If a thorough debridement and irrigation are performed, the postoperative infection rate is low.

References (23)

  • J. Alonzo et al.

    External fixation of femoral fractures. Indications and limitations

    Clin. Orthop.

    (1989)
  • A.W. Bach et al.

    Plates versus external fixation in severe open tibial shaft fractures. A randomized trial

    Clin. Orthop.

    (1989)
  • L.B. Bone et al.

    Early versus delayed stabilization of femoral fractures: a prospective randomized study

    J. Bone Joint Surg. [Am]

    (1989)
  • R.J. Brumback et al.

    Intramedullary nailing of open fractures of the femoral shaft

    J. Bone Joint Surg. [Am]

    (1989)
  • M.W. Chapman

    The role of intramedullary fixation in open fractures

    Clin. Orthop.

    (1986)
  • M.W. Chapman et al.

    Closed intramedullary nailing of femoral shaft fractures

    Orthop. Trans.

    (1982)
  • E.J. Dabezies et al.

    Fractures of the femoral shaft treated by external fixation with the Wagner Device

    J. Bone Joint Surg. [Am]

    (1984)
  • R.J.A. Goris et al.

    Early osteosynthesis and prophylactic mechanical ventilation in the multitrauma patient

    J. Trauma

    (1982)
  • R.B. Gustilo et al.

    Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones. Retrospective and prospective analysis

    J. Bone Joint Surg [Am]

    (1976)
  • G. Kaltenecker et al.

    Lower infection rate after interlocking nailing in open fractures of femur and tibia

    J. Trauma

    (1990)
  • I. Kempf et al.

    Closed locked intramedullary nailing. Its application to comminuted fractures of the femur

    J. Bone Joint Surg. [Am]

    (1985)
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      The ICC was 0.97 (95% CI: 0.93 to 0.99), indicating a nearly perfect agreement between the assessors (Table 4). Union rate data was abstracted from 15 studies irrespective of the timing of fracture fixation (early or delayed IMN).15,16,18–21,23,25,26,28–32 Pooled estimate of effect size for union rate was 97% (95% CI: 94–99%), random effects model, in the presence of significant statistical heterogeneity (I2 = 68.5%, Q = 44.5, df = 14, p < 0.001) (Table 5).

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