Fixation of femoral shaft fractures with a flexible bundle-type nail

In a prospective study, 31 consecutive patients with a femoral shaft fractu re were treated with the Marchetti-Vicenzi intramedullary flexible bundle-t ype nail. Open reduction of the fracture was necessary in 25 of the 31 pati ents (81%). Twenty-five of the 31 fractures (81%) united within 2.5 to 6 mo nths after the operation (mean, 4.2 months). Nonunion occurred in one patie nt (3.2%). Other complications included delayed union in five patients (16% ), femoral shortening in five (16%), breakage of the distal pins in two (6. 5%), and severe varus malunion in two patients (6.5%). Because of the high complication rate in this series, the authors no longer use the Marchetti-V icenzi flexible nail for treatment of femoral shaft fractures.