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. Inthis study, we report on a modified surgical technique with reduction througha small incision for this type of fracture.Methods: From 1994 to 1997, this technique was used on 74 patients with 82 femoralshaft fractures. Seventy patients (76 fractures) with at least 3 years of postoperativefollow-up were included for clinical evaluation. The surgical techniqueinvolves a mini-wound at the fracture site, and fracture reduction isperformed 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, therewas little evidence of fracture union at 6 months. One of these 2 patients wastreated with an open bone graft, and the other was treated with a closedexchanging nail. Finally these 2 patients healed. The mean operation time forthis 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 itis especially suitable for multiple trauma patients.