Fractures of the femoral shaft: A clinical comparison of treatment by traction suspension and intramedullary nailing

Abstract

1. 1. A clinical comparison has been made of twenty-one femoral shaft fractures treated with traction suspension and twenty-one such fractures treated with open intramedullary nailing. 2. 2. The nailing procedure presents very great advantages over the traction suspension method regarding period of recumbency, duration of hospitalization, time and quality of bone healing and the functional results. 3. 3. In selected cases, in the proper hands and under the proper circumstances the advantages offered by open intramedullary fixation offset the risk of open reduction and the peculiar hazards of the nailing procedure. 4. 4. If the stated appropriate conditions for intramedullary nailing cannot be met, treatment by traction suspension is recommended. 5. 5. The management of selected femoral shaft fractures by the open intramedullary nailing procedure is described. Contraindications to the method are noted. The inherent difficulties and possible complications of the procedure are emphasized. 6. 6. All open intramedullary nailings in fractures of the femoral shaft should be accompanied with iliac bone grafts to the fracture site. This may interfere with a true estimation of the effects of the nailing procedure on the process of bone healing but it will assure a more rapid, effective and secure bone union.