Abstract
The primary aim of this study was to determine the outcome of femoral shaft fractures due to gunshot injuries treated with primary intramedullary interlocking nails within 7 days of the injury.
A total of 53 patients were admitted to our institution between November 2003 and November 2005. The average age was 30 years (16–51 years). Associated neuro vascular damage was ruled out by clinical examination, and the patients were then put onto skin traction, given analgesics and tetanus toxoid, and treated with intravenous Cloxacillin 1g 6 hourly. 33 Patients were treated by intramedullary nailing with locking screw fixation at an average of 4 days post injury (range 2–7 days).
All patients were followed up for a minimum of 1 year, and there were no infections. The average time to fracture union was 136 days (120–180 days). The average hospital stay was 9 days. Only 2 patients did not return to their pre-injury activities, and these presented with pain and a limp, requesting disability grants.
We conclude that people sustaining gunshot fractures of the femoral shaft can be treated with intramedullary nailing after the golden 6–8 hours post injury, without the added fear of sepsis. This treatment still leads to a reduced hospital stay, and decreased costs in the management of these patients.
Correspondence should be addressed to: Léana Fourie, CEO SAOA, PO Box 12918, Brandhof 9324 South Africa.
