Technique for closed reduction of femoral shaft fracture using an external support device

Closed reduction of femoral shaft fractures for intra-medullary nailing is a technically challenging procedure. In complicated cases it may require prolonged exposure to ionising radiation during fluoroscopy of the fracture site, and when the fracture parts cannot be controlled, undesirable opening of the fracture haematoma is inevitable. We present a technically simple method for stable preoperative reduction of femoral shaft fractures, using a standard fracture table with a mounted external supporting device that can be controlled in both anterior-posterior and lateral planes to eliminate the deforming forces of thigh muscles. Fourteen mid-shaft femoral fractures were reduced by this method prior to intra-medullary nailing. This is an effective method for achieving stable control of a fracture. It is technically easy to perform and should reduce the radiation exposure of the patient and the surgical team to ionising radiation.