Our first experiences with the Unreamed Femoral Nail (UFN).

The Unreamed Femoral Nail (UFN) has been used in Belgium since April 1995. Compared with the Reamed Femoral Nail (RFN) the new device had some advantages: it can also be used for subtrochanteric fractures and ipsilateral fractures of the femoral neck, there is less iatrogenic damage to the vascularization of the bone, the risk of fat embolism syndrome and ARDS is reduced, the operation is a less time consuming procedure, associated with less blood loss. During a 9 months period, 36 patients have been treated with the UFN: 10 patients with metastatic disease, 12 patients with a subtrochanteric fracture, 14 patients with a diaphyseal fracture. In 4 cases however, previous reaming was necessary. No fat embolism syndrome, nor ARDS were ever observed. The two mechanical complications were not due to the implant itself. Two old patients with a subtrochanteric fracture died within six months after the treatment. In the ten others, no healing problems were observed. In twelve patients with a diaphyseal fracture, the evolution was uneventful. In two open fractures delayed union was observed. Once, the UFN had to be replaced by a RFN with adjacent bone grafts. The average blood loss was 140 ml, average operating time 70 minutes. We conclude that the UFN is an easy and safe procedure, which has enlarged the indications of intramedullary nailing also as a primary treatment in polytrauma patients.