Femoral shaft fractures--a study of closed reduction and open treatment.

A comparative study was made of 58 cases of closed femoral shaft fractures treated by skeletal traction, and 24 cases of closed femoral shaft fractures treated by open reduction with internal fixation.Although complications occurred in some cases, intramedullary nailing appeared to be the most satisfactory method, resulting in primary union, in decreased time of recumbency and time in hospital, in earlier ambulation and in less residual disability. Success of intramedullary nailing depends largely upon adequate training or experience of the surgeon in the technical operative aspects of the procedure and in postoperative management.Placing supplemental autogenous iliac bone chips at the fracture site in closed femoral fractures in which intramedullary nailing is performed appears to enhance callus formation and bony consolidation. Skeletal traction should be utilized on all patients whose general physical condition does not permit operative intervention.