title: Intramedullary nailing without interlocking screws for femoral and tibial shaft fractures.
abstract: BACKGROUND
  Intramedullary fixation is the treatment of choice for diaphyseal fractures of the femur and tibia. Locking the implant can sometimes be cumbersome and time consuming. In our institution, fractures with axial and rotational stability are treated with intramedullary nailing without interlocking.
  
  
  METHODS
  All consecutive patients presented in the University Medical Center Utrecht from October 2003 to August 2009 with acute traumatic diaphyseal fractures of the tibia or femur that were considered axial and rotational stable were included. They underwent internal fixation using intramedullary nails without interlocking. Patient records were evaluated for duration of surgery, perioperative complications, consolidation time and re-operations.
  
  
  RESULTS
  Twenty-nine long bone fractures were treated in 27 patients: 20 men and 7 women, with an average age of 28.9 years (range 15.6-54.4). There were 12 femoral fractures and 17 tibial fractures. Sixteen fractures were closed and 13 were open (10 Gustilo 1, 3 Gustilo 2). The mean operating time was 43 min (range 18-68 min) for tibial fractures and 55 min (range 47-150 min) for femoral fractures. Postoperative complications occurred in six patients. Two patients (three fractures) were lost to follow-up. Healing occurred in 25 of the 26 remaining fractures (96 %) without additional interventions. One tibia was secondarily converted to a standard locked nail because of axial and rotational instability. All patients returned to their pre-injury level of activity.
  
  
  CONCLUSIONS
  The use of intramedullary nailing without interlocking is associated with minimal complications in selected fractures. The advantages include a short operating time and the simplicity of its application.
authors.affiliation: Department of Surgery, University Medical Center Utrecht (UMCU), HP G04.228, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands. dl.tielgroenestege@gmail.com
authors.forename: Dieuwertje L
authors.initials: DL
authors.lastname: Kreb
authors.forename: Taco J
authors.initials: TJ
authors.lastname: Blokhuis
authors.forename: Karlijn J P
authors.initials: KJ
authors.lastname: van Wessem
authors.forename: Mike
authors.initials: M
authors.lastname: Bemelman
authors.forename: Koen W W
authors.initials: KW
authors.lastname: Lansink
authors.forename: Luke P H
authors.initials: LP
authors.lastname: Leenen
mesh_terms: D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D001863:Bone Screws; D005240:Feasibility Studies; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*; D055815:Young Adult