Retrograde closed unreamed interlocking nailing for multiple-level femoral fractures

ABSTRACT

In a prospective study for the treatment of multiple-level femoral fractures, the results of retrograde, closed unreamed, interlocking technique through the inter-condylar notch of the femur were evaluated. Russell-Taylor tibia1 nail was used in all cases. There were twelve fractures [five were open] in twelve patients; ten were males and two were females. Nine patients had other skeletal trauma and one had rupture of the spleen. The average operative time was 65 minutes [range 45 to 100 minutes]. Blood loss was minimal [average 150 ml]. The average follow up was 19 months [range 11-32 months]. Union occurred without additional surgery within 17 weeks in all, but one patient needed autogenous bone grafting about the most proximal fracture site at the twentieth week. All patients regained full knee motion within four weeks. No cases of infections, screw or nail failures, patellofemoral [PF] problems or problems about the hip were recorded. In most of cases [8 out of 10], simultaneous management of other skeletal or non skeletal trauma was possible. At the terminal follow up, it was evident that retrograde closed unreamed interlocking nailing is a competent method in the treatment of multiple-level femoral fractures, especially in those with multi system and/or multiple skeletal trauma