Intramedullary nailing of open femoral shaft fractures

Twenty-seven patients with 28 open femoral shaft fractures were treated by intramedullary nailing. Ten fractures were Grade I, nine Grade II and nine Grade III according to Gustilo. After debridement and irrigation of the wounds, 26 fractures were nailed immediately, whilst two fractures were stabilized at an early stage. Two infections developed. One occurred before intramedullary nailing during a period of femoral traction. Both infections were treated successfully. The authors conclude that primary intramedullary nailing is safe in open femoral fractures of all grades. If a thorough debridement and irrigation are performed, the postoperative infection rate is low.