Treatment of segmental femoral shaft fractures.

In a prospective study, 35 segmental femoral shaft fractures were treated either with closed intramedullary nails (most were Grosse-Kempf interlocking nails) or an open method technique (most were open Küntscher nails with supplementary wires). The follow-up period was at least one year. There was an 82.9% (29/35) union rate and a union period of 6.1 +/- 1.9 months. Knee range of motion was on average 125 degrees. Although there was no statistical difference, the closed intramedullary nailing group showed superiority to the open method group. Complications were not particularly different from those in other type fractures, but could be managed better. Closed nailing technique can be improved with training and experience. Whenever possible, with adequate indications, closed intramedullary nailing is better than open treatment for segmental femoral shaft fractures.