Femoral nailing for metastatic disease of the femur: a comparison of reamed and unreamed femoral nailing

A total of 73 consecutive intramedullary femoral nails were inserted for me tastatic disease of the femur; 43 were reamed and 30 were solid nails. The two groups were similar with regards to age, type of primary tumour, anatom ical site, acute or 'impending' fracture and postoperative survival. The 's olid' nail offers a satisfactory alternative form of stabilisation for meta static disease of the femur with rates of implant failure which are compara ble with the reamed nail. In this series bilateral nailing was not associat ed with any increase in mortality. Contrary to other reports, imposing a de lay in patients with pain and a short life expectancy seems unjustified. Th e use of the 'solid' femoral nail does not prevent sudden death due to mass ive fat embolism. (C) 2000 Elsevier Science Ltd. All rights reserved.