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One hundred and twenty-seven recent femoral shaft fractures in adults were treated by internal fixation.
Intramedullary nailing was supplemented by plating to achieve rigid fixation. This permitted use of the limb without delay and eliminated the risk of rotational deformity. It is felt that plating alone is only advisable for high or low fractures of the femoral shaft and must also provide rigid fixation (strong single or dual plates).
After internal fixation, residual stiffness of the knee is only likely if early movement of the joint is not feasible.
There were two instances of non-union (excluding fractures in carcinomatous deposits) occurring in subtrochanteric fractures in Paget's disease fixed with plates; non-union did not occur after intramedullary nailing.
The open method of treatment is to be preferred if the operating theatre conditions and the surgeon's experience are satisfactory, since the overall results are better and the period of incapacity is reduced.
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© 1971 Published by Elsevier Inc.