Mini-open intramedullary nailing of acute femoral shaft fracture: reduction through a small incision without a fracture table.

BACKGROUND Femoral shaft fractures are usually treated with intramedullary nailing. In this study, we report on a modified surgical technique with reduction through a small incision for this type of fracture. METHODS From 1994 to 1997, this technique was used on 74 patients with 82 femoral shaft fractures. Seventy patients (76 fractures) with at least 3 years of postoperative follow-up were included for clinical evaluation. The surgical technique involves a mini-wound at the fracture site, and fracture reduction is performed with 1 finger or a bone hook without the use of a fracture table. RESULTS Seventy-four fractures (97%) healed in the first 6 months. In 2 patients, there was little evidence of fracture union at 6 months. One of these 2 patients was treated with an open bone graft, and the other was treated with a closed exchanging nail. Finally these 2 patients healed. The mean operation time for this procedure was 75 minutes. CONCLUSION The advantages of this procedure include that no fracture table is needed, there is a shorter operation time, there is a small amount of blood loss, and it is especially suitable for multiple trauma patients.