Closed intramedullary nailing of femoral fractures. A report of five hundred and twenty cases.

Author summary

In the years encompassed by this study there were major advances in trauma care and the overall approach to patients with fractures of the femur changed accordingly. Early in the series there was concern over the possibility of fat embolism from intramedullary reaming and nailing which led to a delay in the nailing for five to seven days after injury. At the end of the study period, immediate internal fixation was performed in all patients with multiple long-bone fractures, including those with bilateral shaft fracture and concomitant injuries to the head, chest, or abdomen. The change to immediate internal fixation of all type-I and II open femoral fractures produced no increase in the number of infections and eased the care of the patients considerably.