title: Intramedullary nailing of femoral shaft fractures: reoperation and return to work.
abstract: OBJECTIVE
  To define the functional outcome and residual disability in adults treated for isolated femoral shaft fractures.
  
  
  METHODS
  A retrospective case study of HMRI records. The mean follow-up was 34.5 months from the time of injury.
  
  
  METHODS
  A tertiary-care teaching hospital.
  
  
  METHODS
  One hundred and thirty adults with femoral shaft fractures. Of these, 47 were isolated and qualified for study.
  
  
  METHODS
  Primary reamed intramedullary nailing performed between April 1987 and September 1990.
  
  
  METHODS
  Reoperation and return to work.
  
  
  RESULTS
  Of the 47 patients, primary healing occurred in 41 (87%) patients; 6 (13%) patients had delayed union or nonunion. Twenty (43%) patients had delayed implant-related pain after fracture healing; 85% of these had relief of pain after implant removal. Of 41 patients available for analysis of function based on return to work, 33 (80%) had returned to work full time in their original occupation at the time of follow-up, and 4 (10%) were working in other full-time employment; 3 (7%) were working part time. Only one (2%) patient was disabled and unable to work.
  
  
  CONCLUSIONS
  Primary reamed intramedullary nailing is an effective method of achieving consistent primary union in adults with femoral shaft fractures. However, the majority of patients will require secondary surgery. Most patients will be able to return to work after these injuries.
authors.affiliation: Department of Surgery, McMaster University, Hamilton, Ont.
authors.forename: D A
authors.initials: DA
authors.lastname: Bednar
authors.forename: P
authors.initials: P
authors.lastname: Ali
mesh_terms: D000328:Adult; D005264:Femoral Fractures / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000601:surgery; D006801:Humans; D010146:Pain; D012086:Reoperation; D012189:Retrospective Studies