Mini-open intramedullary nailing of acute femoral shaft fracture: reduction through a small incision without a fracture table.

Abstract

BACKGROUND: Femoral shaft fractures are usually treated with intramedullary nailing. In this study, we report on a modified surgical technique with reduction through a small incision for this type of fracture. METHODS: From 1994 to 1997, this technique was used on 74 patients with 82 femoral shaft fractures. Seventy patients (76 fractures) with at least 3 years of postoperative follow-up were included for clinical evaluation. The surgical technique involves a mini-wound at the fracture site, and fracture reduction is performed with 1 finger or a bone hook without the use of a fracture table. RESULTS: Seventy-four fractures (97%) healed in the first 6 months. In 2 patients, there was little evidence of fracture union at 6 months. One of these 2 patients was treated with an open bone graft, and the other was treated with a closed exchanging nail. Finally these 2 patients healed. The mean operation time for this procedure was 75 minutes. CONCLUSION: The advantages of this procedure include that no fracture table is needed, there is a shorter operation time, there is a small amount of blood loss, and it is especially suitable for multiple trauma patients.