Closed intramedullary nailing of acute femoral shaft fracture: reduction with help of bone levers through a small incision without opening fracture site

摘要

Background: Femoral shaft fractures are usually treated with intramedullary nailing. In this study, we report a modified closed surgical technique with reduction with bone levers through a small percutaneous stab incision without opening fracture site for this type of fracture. Methods: From June 2015-January 2017, this technique was used on 43 patients with femoral shaft fractures. Patients were followed up postoperatively for clinical evaluation. The surgical technique involves a mini-percutaneous incision slightly distal to the fracture site, and fracture reduction is performed with bone levers without opening the fracture site. Results: 39 patients were included in final assessment. 29 fractures (74.4%) healed in the first 6 month. 35 (89.7%) fractures were united by one year. 4 (10.3%) patients needed bone grafting. The functional results were considered excellent and good in 36 (92.3%) patients, 3 (7.7%) patients had poor results. Conclusions: The advantages of this procedure include that no fracture site is opened, there is a shorter operation time, less radiation exposure and it is especially suitable for multiple trauma and obese patients.