Clinical outcomes of Asian antegrade femoral intramedullary nailing in the treatment of femoral fractures

XU Hua; LIU Ya-Ke; ZHANG Ya-Feng; WANG You-Hua; TAO Ran; CAO Yi; ZHOU Zhen-yu; LU Yue; LIU Fan

doi:10.3969/j.issn.2095-252X.2018.03.004

Abstract：Objective To investigate clinical outcomes of Asian antegrade femoral intramedullary nailing ( A2FN ) in the treatment of femoral fractures. Methods From March 2010 to December 2013, 38 patients with femoral fractures were treated surgically using A2FN in our department. There were 28 males and 10 females. The mean age was 48.8 years ( range: 19 - 70 years ). Causes of injury: 30 cases by traffic accidents, 8 cases by fall injuries. Fracture sites: 15 cases were of middle femoral shaft fractures, 11 cases of subtrochanteric femoral fractures, 8 cases of femoral shaft fractures combining with femoral neck fractures, 4 cases of femoral fragmental fractures. Twenty-two cases underwent close reduction. Sixteen cases underwent limited open reduction. Results The average surgical time was 70 minutes ( range: 50 - 120 min ). The average blood loss during the surgery was 220 ml ( range: 120 -600 ml ). All patients were followed up for an average of 15.1 months ( range: 10 - 22 months ). Fractures healed in all cases. The average healing time was 20.2 weeks ( range: 16 - 32 weeks ). All patients returned to independent living after the operation. No complications such as internal fixation loosening, infection or pulmonary embolism were found. According to HSS standardization, the excellent and good rate was 92.1% ( excellent in 25 cases, good in 10 cases, fair in 3 cases ). The mean Harris score was 91 points postoperatively ( range: 80 - 96 points ). Conclusions A2FN has satisfactory results in the treatment of femoral fractures. It is a less invasive and simple method with fewer complications, which maintains the stability effectively and promotes earlier functional rehabilitation.