Femoral shaft fractures

Summary

It appears that unreamed nailing is significantly faster (operative time) with less blood loss compared with unreamed nailing in the treatment of femoral shaft fractures; however, reamed nailing contributes to faster union times and fewer delayed unions. Neither appears to significantly increase the risk of other complications including pulmonary compromise. Functional outcomes cannot be determined.

• 1 Klein M et al.. 1990;  Reaming versus non-reaming in medullary nailing: interference with cortical circulation of the canine tibia.  Arch Orthop Trauma Surg. 109 314-316
• 2 Heim D, Schlegel U, Perren S. 1993;  Intramedullary pressure in reamed and unreamed nailing of the femur and tibia-an in vitro study in intact human bones.  Injury. 24 (Suppl. 3) 56-64
• 3 Wenda K et al.. 1993;  Pathogenesis and clinical relevance of bone marrow embolism in medullary nailing: demonstrated by intraoperative echocardiography.  Injury. 24 (Suppl.3) 73-81
• 4 Melcher GA et al.. 1995;  Influence of reaming versus nonreaming in intramedullary nailing on local infection rate. Experimental investigation in rabbits.  J Trauma. 39 1123-1128
• 5 Runkel M et al.. 1994;  Knochenheilung nach unaufgebohrter Marknagelung.  Unfallchirurg. 97 1-7