Purpose: Leg fractures are a daily problem in orthopaedic surgery. The frequency has increased due to the growing number of traffic accidents. Social impact is important because the injured population is young and active. The purpose of this work was to analyse anatomic and functional results obtained in a series of patients and to identify indications and limitations of centro-medullary alignment nailing for the treatment of leg fractures.

Material and methods: This series included 207 leg fractures treated with this method at the Kassab Orthopaedic Institute. There were 174 men and 33 women, mean age 35 years (15–75). Male predominance was considerable (84%). Centromedullary nailing was completed with a plaster cast and weight bearing after a mean four to five weeks with a Sarmiento walking case until bone healing.

Results: Results were analysed at mean 12 months follow-up (4 months–18 years). Bone healing was achieved in 99% of the cases within a mean time of 15.3 weeks (6–66 weeks). There were 16 cases with a deformed callus (7.8%) predominantly in varus (n=10) and thirteen secondary dislocations (6.3%). This was significantly more frequent for fractures of the proximal third in comparison with the mid third, or comminutive bifocal fractures, and when weight bearing occurred before the fourth week.

Discussion: The functional outcome showed pain at walking in 15% of the patients. Walking distance was unlimited in three-quarters of the patients and joint motion was good. Alignment nailing is a reliable easy to use technique providing satisfactory results for the treatment of simple fractures of the mid third of the leg. Fractures of the upper and lower third, as well as bifocal and comminutive fractures require a locked nail to neutralise the risk of secondary displacement and misalignment callus.