Retrograde nailing is an attractive method for stabilisation of femoral shaft fractures in cases of polytrauma, ipsilateral pelvic, acetabular, tibial and femoral neck fractures, bilateral femoral fractures, obese and pregnant patients. However, retrograde nailing may result in complaints about the knee. The purpose of this study was to evaluate the incidence and risk factors of lasting knee pa...

Femoral midshaft fracture is one of the most common clinical injuries and is often caused by high-energy traffic accidents. Intramedullary nailings, plates, and external fixators are all used as treatment alternatives for a variety of patients depending on fracture location, displacement, comminution, soft tissue condition, and local tradition. Locked intramedullary nailing is currently the pre...

We describe a case of well leg compartment syndrome following unilateral lithotomy position in a patient undergoing contralateral antegrade intramedullary femoral nailing. Following two-incision four compartment fasciotomy, the patient recovered with no residual defects. We dissuade use of the hemilithotomy position for antegrade femoral nailing procedures in favour of another previously descri...

Intramedullary nailing is the accepted treatment of femoral and tibial shaft fractures. Improvements in surgical techniques and implant designs have extended indications for nailing to metaphyseal fractures of the proximal tibia, distal tibia and the distal femur. Malalignment can still occur with intramedullary nailing of these fractures. Among many techniques that have been described, the use...

BACKGROUND There are many ways to treat aseptic non-union of femoral shaft fractures with reported varied success rate. Amongst all these, Exchange nailing is the simplest and most successful technique for treating aseptic non union of femoral shaft fractures. We have carried out a prospective study in the Department of Trauma & Orthopaedics, Ayub Medical College Abbottabad to analyse the role ...

ABSTRACT In this retrospective study, we present our experience using open Küntscher nailing (K-nailing) which is still performed in developing countries for femoral fractures. Of 157 acute fractures treated between January 2003 and December 2009, 100 were stable (63.7%) and 135 were located within the middle third of the shaft (86%). Comminution was absent or minimal in 135 (86%) cases. Fractu...

A bent femoral intramedullary nail due to secondary trauma presents unique challenges for nail extraction and subsequent exchange nailing. This article describes a case of a 25 year-old male patient who presented with a bent femoral intramedullary Kuntscher’s nail following a repeat trauma after a fall from stairs. The described surgical technique illustrates a simple method to straighten the b...

Rotational deformity following intramedullary nailing may cause symptoms and require surgical correction by osteotomy. Reamed, locked intramedullary nailing may be performed, but concern about cortical blood supply and potential pulmonary dysfunction from reaming have led many surgeons to limit this and use smaller diameter nails. Slotted nails are commonly used but are less stiff in torsion th...

intramedullary nailing of femoral shaft fractures, first introduced by Hey Groves in 1918 and later popularised by K#{252}ntscher (1940, 1958, 1967), B#{246}hler (1951), Street (1951) and Lottes ( 1953), is in most current textbooks described as a routine surgical operation. It is regarded as the method of choice in transverse and short oblique fractures of the femoral shaft (B#{246}hler 1951 :...

BACKGROUND Stabilization of fractures with an intramedullary nail is a widespread technique in the treatment of femoral shaft fractures in adults; however, to ream or not to ream is still being debated. OBJECTIVES The primary objective of this study was to determine clinical results following unreamed versus ream intramedullary nailing of femoral fractures. PATIENTS AND METHODS Between Janu...