ABSTRACT

Here we present a retrospective evaluation of the functional outcomes of 48 patients who underwent antegrade locked intramedullary nailing for acute femoral shaft fracture or non-union.

A total of 52 antegrade locked intramedullary nailings were performed in the 48 pa-tients included in the study. In 27 of the acute femoral shaft fractures, fixation was provided via unreamed antegrade locked intramedullary nailing. In 4 acute femoral fractures and in all 21 cases of nonunion, fixation was provided via reamed antegrade locked intramedullary nailing. Average age was 40.2 years (range 17-80 years). Of these patients, 16 were female (33.3%) and 32 were male (66.7%).

Patient data obtained during follow up were evaluated according to the Thoresen criteria, in which lower extremity function is graded in terms of femoral axis deformity, femoral shortening, knee range of motion and pain or oedema. Patients were followed up for an average of 21 months (range 10-46 months). Union was found in all patients except one (98.07%). Superficial infection occurred in three patients, and in one of these a deep infection developed. In the acute fracture group, one patient with a Winquist type IV fracture had a history of gastrointestinal bleeding and could not be given anticoagulants, and developed a deep venous thrombosis. In the nonunion group, one patient developed pulmonary emboli on the 4th postoperative day.

Intramedullary nailing is an effective treatment method for both acute femoral shaft fracture and nonunion. It provides rigid stabilization, and the reamed method is associated with less frequent failures compared to the unreamed method.

Keywords: femur, fracture fixation, fracture healing, intramedullary nailing