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Twenty-seven patients with 28 open femoral shaft fractures were treated by intramedullary nailing. Ten fractures were Grade I, nine Grade II and nine Grade III according to Gustilo.
After debridement and irrigation of the wounds, 26 fractures were nailed immediately, whilst two fractures were stabilized at an early stage.
Two infections developed. One occurred before intramedullary nailing during a period of femoral traction. Both infections were treated successfully.
The authors conclude that primary intramedullary nailing is safe in open femoral fractures of all grades. If a thorough debridement and irrigation are performed, the postoperative infection rate is low.
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- External fixation of femoral fractures. Indications and limitations.Clin. Orthop. 1989; 241: 83
- Plates versus external fixation in severe open tibial shaft fractures. A randomized trial.Clin. Orthop. 1989; 241: 89
- Early versus delayed stabilization of femoral fractures: a prospective randomized study.J. Bone Joint Surg. [Am]. 1989; 71A: 336
- Intramedullary nailing of open fractures of the femoral shaft.J. Bone Joint Surg. [Am]. 1989; 71A: 1324
- The role of intramedullary fixation in open fractures.Clin. Orthop. 1986; 212: 26
- Closed intramedullary nailing of femoral shaft fractures.Orthop. Trans. 1982; 6: 326
- Fractures of the femoral shaft treated by external fixation with the Wagner Device.J. Bone Joint Surg. [Am]. 1984; 66A: 360
- Early osteosynthesis and prophylactic mechanical ventilation in the multitrauma patient.J. Trauma. 1982; 22: 895
- Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones. Retrospective and prospective analysis.J. Bone Joint Surg [Am]. 1976; 58A: 453
- Lower infection rate after interlocking nailing in open fractures of femur and tibia.J. Trauma. 1990; 30: 474
- Closed locked intramedullary nailing. Its application to comminuted fractures of the femur.J. Bone Joint Surg. [Am]. 1985; 67A: 709
- Immediate nailing of open fractures of the femoral shaft.J. Bone Joint Surg. [Am]. 1988; 70A: 812
- Müller M.E. Nazarian S. Kock P. The Comprehensive Classification of Fractures of Long Bones. Springer-Verlag, Berlin1990: 130
- Primary intramedullary nailing of open femoral shaft fractures.J. Trauma. 1991; 31: 113
- Intramedullary nailing of long-bone fractures — current concepts. Part II. Effects of medullary nailing on the normal blood supply of diaphyseal cortex.in: Instructional Course Lectures, The American Academy of Orthopedic Surgeons. Vol. 22. C.V. Mosby, St. Louis1973: 161
- Open fractures. Long-term results in 200 consecutive cases.Clin. Orthop. 1979; 138: 132
- Closed or open intramedullary nailing of femoral shaft fractures? A comparison with conservatively treated cases.J. Bone Joint Surg. [Br]. 1979; 51B: 313
- Results after internal fixation of comminuted fractures of the femoral shaft with DC plates.Clin. Orthop. 1979; 138: 74
- Fractures of the femoral shaft: a prospective study of closed intramedullary nailing, modified open intramedullary nailing, and castbracing.Southern Med. J. 1982; 75: 827
- Prinzipien der primärversorgung von frakturen mit Weichteilschaden.Orthop. 1983; 12: 9
- Medullary nailing according to the Swiss study group principles.Clin. Orthop. 1979; 138: 45
- The acute effects of periosteal stripping and medullary reaming on regional bone blood flow.Clin. Orthop. 1978; 131: 266
- Closed intramedullary nailing of femoral fractures. A report of five hundred and twenty cases.J. Bone Joint Surg [Am]. 1984; 66A: 529
Accepted: March 31, 1994
© 1994 Published by Elsevier Inc.