Techniques of obtaining and maintaining reduction during nailing of femur fractures.

摘要

Intramedullary nailing is the gold standard for the treatment of most adult femoral shaft fractures, and is becoming increasingly common for the treatment of many pertro-chanteric hip fractures. Fracture reduction and nail starting point are critical for successful outcomes, especially as the indications for intramedullary nailing have expanded beyond simple diaphyseal fractures. This article reviews useful technical tips for fracture reduction and intramedullary nailing of adult femoral fractures. Without a clear understanding and ability to use many of these techniques, the difficulty involved in reduction and implant insertion can increase dramatically. Additionally, knowledge of deforming forces acting on various fracture patterns is essential in the surgical treatment of these often complex fractures.