Retrograde tibial nail for femoral shaft fracture with severe degloving injury.

From the Orthopaedic Surgery; Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Taipei. Received: Jul. 10, 2003; Accepted: Sep. 3, 2003 Address for reprints: Dr. Jiun-Yih Su, Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital. 5, Fushing Street, Gueishan Shiang, Taoyuan, Taiwan 333, R.O.C. Tel.: 886-3-3281200 ext. 2423; Fax: 886-3-3281520; E-mail: skyyangortho@yahoo.com.tw Femoral shaft fractures are typically the result of high-energy trauma, and thus, are usually associated with multiple injuries. Closed static locking intramedullary nailing is the treatment of choice for femoral shaft fractures, with a union rate above 95% and low complication rates. Retrograde nailing has been developed for successful management of femoral peritrochanteric fractures since 1980, however, an intra-articular knee entry is used. Longterm degeneration has still not been resolved, and remains a major concern. Recently, several research teams have investigated the indications for, and the feasibility of, retrograde intramedullary nailing for femoral shaft fractures. However, these specifically designed retrograde femoral nails are reserved for properly selected cases and particular situations.