Abstract
We report our experience on complications of intra-medullary nailing on 150 femoral shaft fractures.
Material concerns 147 patients (103 men and 44 women) that were operated in a 7 years period. Mean age was 37 years old (15–77). Thirty patients were older than 65 years. Indications for femoral intramedullary nailing were 120 acute fractures (7 pathological), 9 non-unions, 2 malunions and 19 fractures with delayed union previously operated by another method. Twenty two were polytrauma patients. Twenty one fractures were open (grade a and b). Various types of reamed long antegrade nails were used in 117 cases and a long g-nail in 33 cases.
Main complications were: shortening 10, heterotopic ossification 6, knee stiffness 8, fat embolism 2, deep venous thrombosis 4, pulmonary embolism 2, superficial wound infection 8, deep infection 1, lengthening 4, rotational deformity 10, nonunion 0, missed distal screw targeting 10, drill breakage 7, malposition of the nail 7, additional intraoperative fracture occurrence 7. In 60 cases the insertion of the guide was performed by a small incision at the fracture site. Mean union time was approximately 4 weeks shorter when a closed reduction was performed.
Technical complications in the majority of cases affected fractures that were operated after midnight. Elderly patients (> 65 years old), were most probably to be subjected a complication while less complications occurred in younger patients. A well prepared operating room and prevention of surgeons fatigue is needed to reduce complications.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
