Abstract
In this retrospective study, we present our experience using open Küntscher nailing (K-nailing) which is still performed in developing countries for femoral fractures. Of 157 acute fractures treated between January 2003 and December 2009, 100 were stable (63.7%) and 135 were located within the middle third of the shaft (86%). Comminution was absent or minimal in 135 (86%) cases. Fracture union was achieved at an average of 14 weeks (range, 10 - 25). The duration of follow-up was 17 months (range, 6 - 36). Final evaluation showed that 129 (82.2%) patients had a good result according to modified Kempf's criteria. The predominant complications were infection (n=5; 3.2%), nonunion (n=9; 5.5%), implant failure (n=11; 7%), and malunion (n=27; 17.3%). Open reduction and fixation with a tight fitting Knail can give good results in selected acute femoral shaft fractures but knowledge of potential complications is needed. femoral shaft fracture, Intramedullary nailing, Open reduction.
Highlights
Closed locked intramedullary nailing (IM nailing) is the treatment of choice for most femoral shaft fractures (FSFs) .1-3 This requires use of an image intensifier, a fracture table, appropriate instrumentation, and specialized implants which are not available to most surgeons in developing nations
Open reduction and internal fixation with K-nails is a readily available and preferred method for treatment of FSFs as it carries the advantages of relatively low cost, short duration of surgery, acceptable intraoperative bleeding in acute fractures, and reasonable clinical outcomes[4,5]
This study presents the treatment course and subsequent results of open unreamed and unlocked K-nailing in patients treated for FSFs, with emphasis on surgical errors and complications
Summary
Closed locked intramedullary nailing (IM nailing) is the treatment of choice for most femoral shaft fractures (FSFs) .1-3 This requires use of an image intensifier, a fracture table, appropriate instrumentation, and specialized implants which are not available to most surgeons in developing nations. Closed locked intramedullary nailing (IM nailing) is the treatment of choice for most femoral shaft fractures (FSFs) .1-3. This requires use of an image intensifier, a fracture table, appropriate instrumentation, and specialized implants which are not available to most surgeons in developing nations. Open reduction and internal fixation with K-nails is a readily available and preferred method for treatment of FSFs as it carries the advantages of relatively low cost, short duration of surgery, acceptable intraoperative bleeding in acute fractures, and reasonable clinical outcomes[4,5]. This study presents the treatment course and subsequent results of open unreamed and unlocked K-nailing in patients treated for FSFs, with emphasis on surgical errors and complications Since the advent of Surgical Implant Generation Network (SIGN) nails, open K-nailing is no longer the common procedure for nailing FSFs .6,7 This study presents the treatment course and subsequent results of open unreamed and unlocked K-nailing in patients treated for FSFs, with emphasis on surgical errors and complications
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