How risky is early intramedullary nailing of femoral fractures in polytraumatized patients?

There is controversy over both the time of intervention and the technique o f surgical stabilisation of femoral fractures in polytraumatized patients. Retrospective analysis of data on 55 such patients revealed that stabilisat ion within the first 24 h using locked, unreamed nails had no negative impa ct on the rate of pulmonary complications. The frequency of complications w as assessed by comparing immediate intramedullary (IM) osteosynthesis with extramedullary stabilisation in patients with or without concomitant blunt thoracic trauma. Due to the small study population and discrepancies the si ze of subgroups, no definite statistical conclusions were possible. However , our results suggest that the frequency of complications is determined by the overall severity of injury rather than by the type of acute surgical tr eatment. (C) 2001 Elsevier Science Ltd. All rights reserved.