title: Open grade III fractures of femoral shaft: Outcome after early reamed intramedullary nailing.
abstract: BACKGROUND
  Open grade III fractures of femur are a challenging therapeutic problem as most of them are associated with multiple trauma. Method used for skeletal stabilization of these fractures should limit further soft tissue damage, bacterial spread and morbidity in addition to its ease of application, providing mechanical support and restoring normal alignment.
  
  
  METHODS
  Forty-six patients with open grade III fractures of femoral shaft were included in the study. There were 10 grade IIIA, 34 grade IIIB and two grade IIIC fractures that were treated with early reamed intramedullary nailing with adequate management of soft tissue. Patients were reviewed retrospectively.
  
  
  RESULTS
  Mean time of union was 27 weeks. Infection rate was 4% and non-union rate was 9%. There were two cases (4%) with limb shortening. No case of angular or rotational deformity was noted.
  
  
  CONCLUSIONS
  Early reamed intramedullary nailing for open grade III fractures of femoral shaft, after giving due respect to the soft tissue injury, gives satisfactory results with proper alignment, good range of motion, short rehabilitation period and low infection rate.
  
  
  METHODS
  Level IV. Retrospective therapeutic study.
authors.affiliation: Department of Orthopedics, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India. drdaljitortho@gmail.com
authors.forename: D
authors.initials: D
authors.lastname: Singh
authors.forename: R
authors.initials: R
authors.lastname: Garg
authors.forename: J L
authors.initials: JL
authors.lastname: Bassi
authors.forename: S K
authors.initials: SK
authors.lastname: Tripathi
mesh_terms: D000328:Adult; D005260:Female; D005264:Femoral Fractures / Q000145:classification / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000379:methods; D005597:Fractures, Open / Q000145:classification / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult