Closed antegrade interlocked nailing of femoral shaft fractures operated up to 2 weeks postinjury in the absence of a fracture table or C-arm.
BACKGROUND
We present our technique of closed nailing in diaphyseal femoral fractures treated between 1 to 14 days postinjury. The purpose of the study was to demonstrate the fact that such fractures can be treated closed in the absence of a fracture table or C-arm.


METHODS
In all, 200 consecutive closed femoral fractures were fixed 1 to 14 days postinjury during a period of 2 years. Skeletal traction was applied immediately at admission and sufficient weight was applied to overcome muscle spasm. In most cases, a closed nailing was successfully performed. Distal locking was achieved with either a medinov nail with wings for distal locking, or a standard nail with a jig for the distal lock.


RESULTS
The average age of the patients was 30 years. Follow up ranged from 6 to 12 months. Mean duration of follow up was 10 months. All patients had a functional range of movement at the hip and knee with a normal gait. The average time taken for surgery was 90 minutes with an average blood loss of 50 to 100 mL. Time in hospital after surgery was 2 to 10 days.


CONCLUSIONS
Delayed closed nailing of femoral fractures can be achieved without a C-arm or a fracture table provided adequate skeletal traction is applied preoperatively and proper attention is paid to the surgical steps as described.
Aiyer
Sujata
S
Department of Orthopaedics, Lokmanya Tilak Medical College, Mumbai, India. sujata64@hotmail.com
Jagiasi
Jairam
J
Argekar
Harshad
H
Sharan
Sudhir
S
Dasgupta
Bibhas
B
D000328:Adult; D000368:Aged; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000534:rehabilitation / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013523:Surgical Equipment; D014143:Traction