Incidence of local complications after intramedullary nailing and after plate fixation of femoral shaft XXXX .

@entity1 @entity281 @entity174
A consecutive series of 378 @entity1 with 381 acute adult femoral shaft @entity174 in previously intact femora admitted during a 10-year period was reviewed for the incidence of local complications including malunion. The majority, 282 @entity174 (74%), were caused by motor vehicle accidents. The median age of the @entity1 was 28 years. The policy of management was internal fixation of the @entity174 on the day of admission. The method of treatment was intramedullary nailing (K  ntscher or interlocking nailing) in 279 and plate fixation in 102 @entity174 . A local complication occurred in 90 @entity1 (24%). Of these 90 cases 24 had malunion only while in the remaining 66 @entity1 there was mechanical failure of fixation in 27, @entity281 in 20 (5.3% of the total), delayed union or nonunion in 15, and refracture in four @entity1 . Concurrent injuries in the lower extremities were associated with a significantly increased frequency of delayed union, nonunion, and refracture. In 41 @entity1 (11%) a total of 58 reoperations had to be undertaken because of local complications. There was an over-representation of plated @entity174 among those @entity1 suffering a local complication classified as severe, 24 out of 37 (chi 2 = 30.3; p less than 0.001). Consequently, we now only exceptionally use plate fixation in the management of femoral shaft @entity174 .
