[Treatment of femoral shaft fractures with expandable intramedullary nail].
BACKGROUND
Femoral shaft fractures are usually seen in the young population as a result of high energy traumas and are often accompanied by major organ injuries. In this paper, we aimed to assess the clinical results of expandable femoral intramedullary nails in the treatment of 20 femoral shaft fractures.


METHODS
The average age was 34.7. One fracture was the result of a gunshot wound, type 3A open fracture, and the other 19 fractures were closed. Under fluoroscopic control, all patients underwent elective closed reduction and internal fixation with intramedullary expandable femoral nails (Fixion, Disc-O-Tech; Israel). In case of failed or unacceptable closed reduction, open reduction was achieved with a second incision over the fracture site. Average operation time was 26.3 minutes.


RESULTS
Full union was achieved in all patients. The shortest union time was 12 weeks and the longest 24 weeks, with an average of 15.2 weeks. Results in 15 patients (75%) were excellent, in 4 patients (20%) good and in 1 patient (5%) moderate according to Thorensen criteria.


CONCLUSIONS
Use of expandable nails provides union without major complications and offers advantages such as less exposure to radiation as seen in distal locking of classical intramedullary nails. In conclusion, the good results of this study show that the expandable femoral intramedullary nail provides a successful option to classical intramedullary nails.
Cilli
Feridun
F
Department of Orthopaedics and Traumatology, GATA Haydarpaşa Training Hospital, Istanbul, Turkey. fcilli@yahoo.com
Mahiroğullari
Mahir
M
Pehlivan
Ozcan
O
Keklikçi
Kenan
K
Kuşkucu
Mesih
M
Kiral
Ahmet
A
Avşar
Serdar
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000473:pathology / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing; D005596:Fractures, Closed / Q000473:pathology / Q000601:surgery*; D005597:Fractures, Open / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult