Unreamed intramedullary nailing for pathological femoral fractures - Good results in 30 cases

We have used the AO unreamed femoral nail for stabilization of impending an d complete pathological fractures since March 1994. 27 patients with 30 pathological fractures (23) or impending fractures (7) of the femur were retrospectively analyzed. These included 18 subtrochanter ic fractures, 11 shaft fractures and 1 distal fracture. The mean age of the patients was 68 (51-84) years. All patients were treated with a solid femo ral nail inserted by an unreamed technique. The nail was inserted through a minimally invasive approach and with a median surgical time of 55 (35-70) minutes. A reconstructive proximal locking option (spiral blade) was used i n 25 cases, There were no intraoperative complications, no operative mortality. Reliabl e skeletal stability was obtained in all cases and most were able to mobili ze early with minimum discomfort. 1 case was revised for a secondary fractu re through a distal metastasis at 6 months. The median survival was 5 (2-9) months. Unreamed nailing with the AO solid femoral nail appears to be a go od option for the stabilization of pathological femoral fractures.