Closed Locked Intramedullary Nailing ITS APPLICATION TO COMMINUTED FRACTURES OF THE FEMUR

ABSTRACT: For many fractures of the femoral shaft, closed intramedullary nailing will not control rotation or telescoping of the fragments. Locked intramedullary nailing combines closed nailing with the percutaneous insertion of screws that interlock the bone and nail. This method permits static locking that controls rotation and telescoping and subsequently conversion to dynamic locking when weight-bearing is started after approxi-mately twelve weeks. By providing greater stability, this method extends the indications for intramedullary nail-ing to severely comminuted, oblique, and spiral frac-tures as well as to fractures complicated by loss of bone and fractures in the proximal and distal ends of the femoral shaft. Of fifty-two patients with forty-nine severely com