In a prospective study from October 2002 to December 2003, we evaluated 102 femoral fractures treated with the new Synthes antegrade femoral nail. It is a titanium femoral nail with a recon locking option, distal dynamisation slot and trochanteric entry point.

There were 99 patients (76 males and 23 females), three of whom had bilateral fractures and 42 polytrauma. The mean age was 36 years (13 to 87). The mean Injury Severity Score was 42 (23 to 65). Motor vehicle accidents were the cause of 44 fractures and gunshot injuries the cause of 37. There were 25 transverse fractures (AO 32-A), 37 wedge type fractures (AO 32-B) and 40 complex (AO 32-B) fractures. There were 38 Gustilo type-II and type-III open fractures. Surgery was performed within 24 hours in 80% of the fractures. Nine required open reduction. Unreamed nails were inserted in 38 patients.

All fractures united. However, 11 showed angulations greater than 5°. Two patients had shortening of more than 1 cm, one of them requiring reoperation. One patient sustained a iatrogenic fracture, four developed fat embolism syndrome and three had DVT. Three patients had early superficial wound infection and two had late infections with a draining sinus. One locking screw broke.

We found this to be a reliable femoral nail with a safe entry point.