• Feridun Cilli, Mahir Mahiroğullari, Ozcan Pehlivan, Kenan Keklikçi, Mesih Kuşkucu, Ahmet Kiral, and Serdar Avşar.
• Department of Orthopaedics and Traumatology, GATA Haydarpaşa Training Hospital, Istanbul, Turkey. fcilli@yahoo.com
• Ulus Travma Acil Cer. 2009 Jul 1;15(4):383-9.

BackgroundFemoral shaft fractures are usually seen in the young population as a result of high energy traumas and are often accompanied by major organ injuries. In this paper, we aimed to assess the clinical results of expandable femoral intramedullary nails in the treatment of 20 femoral shaft fractures.MethodsThe average age was 34.7. One fracture was the result of a gunshot wound, type 3A open fracture, and the other 19 fractures were closed. Under fluoroscopic control, all patients underwent elective closed reduction and internal fixation with intramedullary expandable femoral nails (Fixion, Disc-O-Tech; Israel). In case of failed or unacceptable closed reduction, open reduction was achieved with a second incision over the fracture site. Average operation time was 26.3 minutes.ResultsFull union was achieved in all patients. The shortest union time was 12 weeks and the longest 24 weeks, with an average of 15.2 weeks. Results in 15 patients (75%) were excellent, in 4 patients (20%) good and in 1 patient (5%) moderate according to Thorensen criteria.ConclusionUse of expandable nails provides union without major complications and offers advantages such as less exposure to radiation as seen in distal locking of classical intramedullary nails. In conclusion, the good results of this study show that the expandable femoral intramedullary nail provides a successful option to classical intramedullary nails.

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