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  • Title: Closed antegrade interlocked nailing of femoral shaft fractures operated up to 2 weeks postinjury in the absence of a fracture table or C-arm.
    Author: Aiyer S, Jagiasi J, Argekar H, Sharan S, Dasgupta B.
    Journal: J Trauma; 2006 Aug; 61(2):457-60. PubMed ID: 16917468.
    Abstract:
    BACKGROUND: We present our technique of closed nailing in diaphyseal femoral fractures treated between 1 to 14 days postinjury. The purpose of the study was to demonstrate the fact that such fractures can be treated closed in the absence of a fracture table or C-arm. METHODS: In all, 200 consecutive closed femoral fractures were fixed 1 to 14 days postinjury during a period of 2 years. Skeletal traction was applied immediately at admission and sufficient weight was applied to overcome muscle spasm. In most cases, a closed nailing was successfully performed. Distal locking was achieved with either a medinov nail with wings for distal locking, or a standard nail with a jig for the distal lock. RESULTS: The average age of the patients was 30 years. Follow up ranged from 6 to 12 months. Mean duration of follow up was 10 months. All patients had a functional range of movement at the hip and knee with a normal gait. The average time taken for surgery was 90 minutes with an average blood loss of 50 to 100 mL. Time in hospital after surgery was 2 to 10 days. CONCLUSIONS: Delayed closed nailing of femoral fractures can be achieved without a C-arm or a fracture table provided adequate skeletal traction is applied preoperatively and proper attention is paid to the surgical steps as described.
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