Abstract
We report the postoperative outcomes of treatment for open femoral shaft fractures including Gustilo type III a fracture, with primary fixation using an intramedullary nail within the golden hour.
Ten fractures were treated by primary fixation using intramedullary nails. The average patient age at injury was 26.1 years (range: 11 to 62 years). The average follow-up was 26.1 months (range: 17 to 48 months). Fracture were classified as Gustilo type I : 2 cases, Type II : 6 cases, type III a : 2 cases. AO classification showed type A: 2 cases, type B: 7 cases, type C: 1 case.
Treatment progressed smoothly without problems and 7 achieved union. Pseudarthrosis occurred in 2 fractures, and union was achieved by exchange of nail and bone transplantation. One Gustilo type III a fracture developed an infection. Though the causal relation between infection and response to operation in Gustilo classification and reaming was not clear for this case, primary fixation should be performed at the least when reaming is necessary.
