RETROGRADE INTRAMEDULLARY NAILING, WITHOUT REAMING, OF FRACTURES OF THE FEMORAL-SHAFT IN MULTIPLY INJURED PATIENTS

Twenty consecutive multiply injured patients who had a total of twenty -two fractures of the femoral shaft were managed with intramedullary n ailing without reaming. A retrograde technique through the intercondyl ar notch of the knee was used. All patients were followed for at least one year or until union of the fracture. The operative time for the n ailing averaged seventy-five minutes (range, thirty-five to 105 minute s). Union of the fracture occurred at an average of fifteen weeks. The re were three non-unions and one rotational malunion. There were no in fections, and no nail or screw failed. Normal motion of the knee was r egained by all patients, except one who had had an ipsilateral disloca tion of the knee, On the basis of these preliminary results, we conclu ded that retrograde nailing is a safe and effective technique for mult iply injured patients, The apparently higher prevalence of non-union c ompared with that reported with antegrade nailing with reaming warrant s additional study.