bed-assisted closed reduction intramedullary nailing for femoral shaft fracture

Objective: To compare treatment of femoral shaft fractures using traction bed assisted closed reduction (CR) or conventional open reduction (OR) for intramedullary nail fixation. Methods: The study group consisted of 126 patients with femoral shaft fractures who were treated via intramedullary nail fixation from July 2009 to May 2013. Traction bed assisted CR was adopted in 71 patients, while OR was performed in 55 cases. Data regarding surgery duration, intraoperative blood loss, complications and recovery of postoperative hip and knee function were abstracted and analyzed. Results: In patients with non-comminuted fractures, no significant differences were observed between the CR and OR groups in operation time (P = 0.560) or blood loss (P = 0.739). However, in patients with comminuted fractures, operation time (P = 0.024) and blood loss (P = 0.008) were significantly reduced in the table traction group when compared with the OR group. All patients in the CR group had prolonged positioning time (P = 0.000), but no statistically significant differences were found between the open and CR groups in the function of the hip (P = 0.058) or knee (P = 0.625) of the injured limb. Conclusions: Treatment of comminuted femoral shaft fractures using traction bed assisted CR during intramedullary nail fixation had the advantages of reduced surgical time and less intraoperative blood loss when compared with conventional OR.