title: Femur fractures caused by gunshots: treatment by immediate reamed intramedullary nailing.
abstract: Fractures of the femur caused by gunshots are increasingly common. There is no standard treatment of these fractures since there are no clear guidelines relating these injuries to open fracture classification. We reviewed our experience with such fractures, which included 65 patients who had an immediate reamed intramedullary nail placed as treatment. The soft-tissue injury, vascular injury, missile velocity, and length of hospital stay were evaluated. We found that all patients healed with no infections. The overall morbidity and average hospital stay were decreased compared with studies advocating delayed intramedullary nailing and prolonged intravenous antibiotics. We recommend that patients with fractures of the femur caused by gunshots are candidates for immediate reamed intramedullary nailing providing that there is only mild to moderate soft-tissue contamination and no evidence of major devitalization.
authors.affiliation: Department of Orthopedic Surgery, Kings County Hospital Center, Brooklyn.
authors.forename: M
authors.initials: M
authors.lastname: Bergman
authors.forename: P
authors.initials: P
authors.lastname: Tornetta
authors.forename: M
authors.initials: M
authors.lastname: Kerina
authors.forename: H
authors.initials: H
authors.lastname: Sandhu
authors.forename: G
authors.initials: G
authors.lastname: Simon
authors.forename: G
authors.initials: G
authors.lastname: Deysine
authors.forename: F
authors.initials: F
authors.lastname: Alcindor
mesh_terms: D000293:Adolescent; D000328:Adult; D001753:Blast Injuries / Q000601:surgery*; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014948:Wounds, Gunshot / Q000601:surgery*