ABSTRACT
Femoral shaft fractures are major causes of mortality and morbidity and are managed with intramedullary nailing [IMN]. In this study we compared the results of open and closed nailing in femoral shaft fractures. Between 1993 and 2001 we managed 136 femoral shaft fractures by IMN [81 closed and 55 open nailings] in 120 patients with mean age of 36.2 years. The mean time of follow up was two years. Radiologic and clinical results were analyzed with SPSS software using student-t and Fisher test. 93.2% healed within six months. 2.9% required dynamization; total union rate was 96%. Full weight bearing was permitted between 5-16 weeks [mean of 10.62 weeks] in the closed method, and 10-20 weeks [mean of 12.83 weeks] in the open method [P<0.001]. Complications included 4.41% nonunions, 2.9% shortening, 10.8% limited range of movement, 1.47% deep infection, and 6.6% malunion. Nonunion was observed in 2 cases in closed and in 4 patients in open method [P = 0.039]. Closed series showed higher rate of malunion [P = 0.181, P = 0.221]. In closed method attention should be paid to malalignment while locking the nail