Close versus open interlocking intramedullary nailing for femoral shaft fracture

Objective To compare the clinical effect of close reduction and open reduction for femoral shaft fracture with interlocking intramedullary nail.Methods 76 cases of femoral fracture were randomized into two groups,of which 37 patients were undergone close reduction,and 39 patients were undergone open reduction.After operation,the volume of blood loss,the period to union,the joints function and complication were compared.Results Blood loss was(220±60)ml in close reduction group and(530±80)ml in open reduction group(P0.05).76 cases were all followed up for 7~15 months.The union period of close reduction group were(4.8±2.1)months,and(7.9±3.6)months,respectively(P0.05).Based on the Kolmert score standardization of knee fuction,the results of 26 cases in close reduction group achieved excellent function,9 good and 2 fair.The excellent and good rate was 94.6%.No infection,delayed union or nonunion was found.For open reduction group,the results of 24 cases achieved excellent function,10 good,4 fair,and 1 poor.The excellent and good rate was 87.2%.6 cases got delayed union,including 4 cases become union by dynamic locking after 3 months and 2 cases got fracture again.1 case occurred deep-infection.And statistical significant were found between two groups(P0.05).Conclusions Close reduction for femoral shaft fracture with interlocking nail is better than open reduction.