Intramedurally Nailing in Fractures of Lower Extremities.

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We report the use of intramedurally nailing in the treatment of 37 fractures of femoral or tibial shaft. In 1988-1993, 25 femoral shaft and 12 tibial shaft fractures in 33 patients were treated with intramedurally nailing. Of 37 fractures, 9 were open fractures and 4 were delayed unions. Interlocking nailing was used and dynamization was performed for 24 fractures.At follow up, 35 of 37 fractures had healed. Two fractures in one patient with renal failure failed to consolidate. These 2 fractures were in one patient, who needed dialysis and had not followed enough aftertreatment. Three nails were broken at the distal interlocking screw hole.In order to get anatomical reduction and to reduce irradiation time, we used an open reduction and nailing method in 26 fractures. In these cases, no infection or no deformity developed but longer period were needed for radiographic consolidation than the closed nailing.In 20 fractures, out of 24 fractures for which the dynalization technique was used, the fracture-healing processes seemed normal, but not apparently proceeded. In 2 fractures, apparent proceeding in fracture healing were observed after removal of the interlocking screws.
中国・四国整形外科学会の論文