Summary
One hundred and three consecutive patients who underwent Kuntscher intramedullary nailing for recent non-pathological single fracture of the femoral shaft showed 13.6% incidence of non-union. The latter complication was not significantly influenced by the type, site, and cause of the fracture nor by sex, timing of the operation, and reaming of the medullary cavity. Conversely, non-union was more common in older patients and in those who were in bad general condition prior to and at the time of operation. Similarly, non-union increased significantly when the nail was too thin, or its lower end did not reach the optimum level (2 cm higher than the joint line), when weight-bearing was started 6 weeks or less after operation and in the presence of post-operative knee stiffness. Two patients presented with broken nails and four with angulated nails in the presence of non-union. Three patients with segmental fracture of the femur showed non-union of the fracture nearer to the middle of the shaft.
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Anderson LD (1971) Errors and complications of medullary fixation of the femur. In: Crenshow AH (ed) Campbell's operative Orthopaedics, 5th ed. CV Mosby Co, St Louis, p 563
Bechtol CO (1954) The principles of fracture fixation. Am Acad Orthop Surg; Instructional Course Lectures. Ann Arbor Michigan: Edwards 11:92–94
Bistrom O (1957) Some sequelae of medullary nailing of long bones. Ann. Chir Gynaecol Fen 46:1–14
Boyed H, Lipinski SW, Wiley JH (1961) Observations on non-union of the shafts of long bones, with a statistical analysis of 842 patients. J Bone Jt Surg 43-A:159–168
Boyd H, Anderson LD, Johnston DS (1965) Changing concepts in the treatment of non-union. Clin Orthop Rel Res 43:37–53
Burwell HN (1971) Internal fixation in the treatment of fractures of the femoral shaft. Injury 2:235–244
Charnley J, Guindy A (1961) Delayed operation in the open reduction of fractures of long bones. J Bone Jt Surg 43-B:664–671
Fowler SB, Riordan DC (1949) Internal fixation of the femur with the Küntscher intramedullary nail. Sth Med J 42:545 -551
Granjos P, Sœur R (1955) L'enclouage centromedulla ire des os longs. Rev Chir Orthop 41:473–475
Hamada G (1975) Emeritus Professor of Orthopaedic Surgery, Alexandria Medical School. Pers. comm.
Küntscher G (1940) Die Marknagelung von Knochenbrüchen. Arch Klin Chir 200:433–455
Lam SJ (1964) The place of delayed internal fixation in the treatment of fractures of the long bones. J Bone Jt Surg 46-B:393–397
Murray CR (1941) The timing of the fracture-healing process. J Bone Jt Surg 23:598–606
Smith JEM (1964) The results of early and delayed internal fixation of fractures of the shaft of the femur. J Bone Jt Surg 46-B:29–31
Smith H, Sage FP (1957) Medullary fixation of forearm fractures. J Bone Jt Surg 39-A:91–98
Soto-Hall R, McCloy NP (1953) Cause and treatment of angulation of femoral intramedullary nails. Clin Orthop Rel Res 2:66–74
Street DM (1951) Medullary fixation of the femur. End results. Am Acad Orthop Surg; Instructional Course Lectures. Ann Arbor, Michigan: Edwards 8:54–59
Street DM (1953) Complications in medullary nailing of the femur. Clin Orthop Rel Res 2:93–101
Urist MR, Mazet R Jr, MacLean FC (1954) The pathogenesis and treatment of delayed union and non-union. J Bone Jt Surg 36-A:931–968
Wickstrom J, Corban MS, Vice GT (1968) Complications following intramedullary fixation of 324 fractured femurs. Clin Orthop Rel Res 60:103–113
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Eid, A.M., Deif, A.I. Aetiological factors in non-union following Küntscher intramedullary nailing of the femur. Arch. Orth. Traum. Surg. 96, 213–220 (1980). https://doi.org/10.1007/BF00457785
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DOI: https://doi.org/10.1007/BF00457785