Manipulation with Schanz screws for closed reduction of femoral shaft fractures during intramedullary nailing.

OBJECTIVE To use Schanz screws as a simple and effective method for closed reduction of femoral shaft fractures. METHODS In the present cohort study, which was carried out in Shohada Orthopedic Center, Tabriz, Iran between January 2004 and February 2005, 30 adult patients, with a mean age of 29 (18-65 years) with femoral shaft fractures underwent closed reduction with Schanz pins. The patients were followed up for 12 months. RESULTS Reduction was satisfactory in 93.3% of patients. The average time for reduction was significantly shorter if treated in the first 48 hours, and if the amount of pre-operative traction approached 15% of the body weight. Reduction time was also shorter in Winquist-Hansen type III and IV fractures than in type I and II fractures (5.9 +/- 0.2 minutes versus 15.7 +/- 0.4 minutes). There was 13% valgus deformity (5-10 degrees), 33% external mal-rotation (5-15 degrees) and 37% shortening (up to 1-3 cm). We encountered no need for blood transfusion or bone grafting. CONCLUSION Schanz screws provide a very effective method for closed reduction of femoral shaft fractures, and complications are similar to or less than other methods, especially if carried out in the first 48 hours after the trauma and if the weight for pre-operative traction approaches 15% of body weight.