Long-term outcome of unreamed intramedullary nails in femur diaphyseal fractures

BACKGROUND We evaluated the results of patients with traumatic femur diaphyseal fracture who had undergone biologic fixation with unreamed intramedullary nailing. METHODS Twenty-five adults with 29 traumatic femur diaphyseal fractures who had undergone unreamed intramedullary nailing at Uludag University School of Medicine, Department of Orthopedics and Traumatology were included in the study between January 1997 and December 2007. Gender, age, cause of injury, fracture type, operation length, time lapse till surgery, blood loss, fluoroscopy duration, early and late complications, time until union, and functional results were noted. Functional results were evaluated with Klemm-Borner and Thoresen systems and Short Form (SF)-36 health survey questions. RESULTS The mean follow-up of the patients was 65.1 +/- 31.6 months (26-138). There was no statistically significant difference between operation length, blood loss and time until union of simple and complex fractures (p>0.05). Furthermore, the SF-36 questionnaire revealed no statistically significant difference between pain scores (p>0.05). CONCLUSION Sparing of the endosteal and periosteal circulation, low infection and high union rates, and good functional outcomes of unreamed intramedullary nailing fixation make it the treatment of choice for simple and comminuted fractures of the femur shaft, especially for multi-trauma patients and patients with cardiopulmonary comorbidities.