[Treatment of femoral shaft fractures and pseudoarthrosis with compressive and interlocking intramedullary nailing].
OBJECTIVE
We evaluated the results of compressive and interlocking intramedullary nailing in femoral shaft fractures.


METHODS
Thirty-three femoral fractures of 30 patients (23 males, 7 females; mean age 36.9 years; range 14 to 80 years) were treated by compressive and interlocking intramedullary nailing. There were 26 closed and seven open (2 type II, 5 type IIIA) fractures. In three femurs, intramedullary nailing was performed due to pseudoarthrosis. According to the Winquist classification, there were 13, 8, 8, and 4 type I to IV fractures, respectively. Clinical, radiographic, and functional results were evaluated according to the Thoresen criteria. The mean follow-up was 29 months (range 6 to 29 months).


RESULTS
The mean operation time was 105.7 minutes. Union was obtained in all the patients within a mean duration of 19.6 weeks. In six cases, dynamization was performed due to insufficient callus formation. The results were excellent in 17 patients (56.7%), good in eight patients (26.7%), fair in three patients (10%), and poor in two patients (6.7%). Complications included shortening (n=3; 2 to 4 cm), varus deformity (n=2; 8 and 11 degrees), external rotation (n=3), restriction in knee flexion (n=3), superficial infection (n=8), trochanteric bursitis (n=3), and irritation of the skin by distal screws (n=2).


CONCLUSIONS
High rates of union with low complication rates makes interlocking intramedullary nailing an appropriate method in the treatment of femoral shaft fractures in adults. Compression with top screws contributes to the stability of fixation by eliminating any looseness through the fracture line.
Yilmaz
Erhan
E
Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Firat University, Elaziğ, Turkey. yilmazerh@yahoo.com
Karakurt
Lokman
L
Bulut
Mehmet
M
Belhan
Oktay
O
Serin
Erhan
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome