The Marchetti-Vicenzi elastic locked nail for the treatment of femoral shaft fractures: a review of 100 consecutive cases

A total of 100 hundred femoral fractures in 97 patients were treated with t he Marchetti-Vincenzi universal bundle elastic nail; six of the fractures w ere open. Closed fractures were classified according to AO and Winquist; op en fractures were classified according to Gustilo. A total of 91 fractures united (average 12 weeks) and six led to non-union. There were two deep and one superficial infections. In three cases, the secondary nails protruded from the anterior cortex of the femoral condyle; in two cases intraoperativ ely and in the third case 2 months postoperatively, due to severe osteoporo sis. The cylindrical part of the nail did not fail, whereas all the seconda ry nails failed in one patient as well as one secondary nail in another pat ient at the level of the fracture; these two cases exhibited non-union. We consider the absence of distal screws the major advantage of this particula r nail, followed by position of the entry point and the limited reaming. We believe that the absence of a pin guide is a disadvantage. The elasticity of the nail has a positive effect in certain cases while in other cases it acts negatively, resulting in a relatively high proportion of non-unions as in our series. Therefore our conclusion is that this, nail is not appropri ate for the treatment of femoral shaft fractures. (C) 2001 Elsevier Science Ltd. All rights reserved.