Intramedullary nailing for open fractures of the femoral shaft: evaluation of contributing factors on deep infection and nonunion using multivariate analysis

Time to Initial Operative Treatment Following Open Fracture Does Not Impact Development of Deep Infection

“…Numerous studies [1][2][3][4][5][6][7][8][9] have questioned the association between delayed surgical treatment and the development of deep infection in open long bone fractures. Schenker et al, 10 in a recent meta-analyses of 3539 open fractures, reported similar findings.…”

The Outcome of Closed, Intramedullary Exchange Nailing With Reamed Insertion in the Treatment of Femoral Shaft Nonunions

“…4 Thus, the incidence of nonunion is reported to be higher than that reported previously 5,6 and may reach 14% in high-grade open femoral fractures. 7 Similarly, a commonly described procedure for the treatment of a femoral shaft nonunion is closed, intramedullary exchange nailing with reamed insertion. This involves the removal of a previously placed implant and reaming the medullary canal to a larger diameter than previously, ideally by 2 mm.…”

Open extremity fractures

“…However, this study was performed in pediatric patients who, in general, have infection rates lower than those of adults and may have a more benign healing course. 16Y20 Noumi et al 9 in a retrospective study performed a multivariate analysis assessing factors that contributed to infection in 88 open femoral fractures. They reported that only Gustilo grade was predictive of infection, and delay (96 hours) in operative debridement did not adversely affect infection rates.…”