A Femoral Intramedullary Nail

¹ Department of Orthopaedic Surgery, Palackého Universita, Olomouc

From November 1954 to June 1956, a period of one and one-half years, fourteen patients were treated at our clinic by means of the intramedullary nail designed by the author. In thirteen patients the lower limb had been surgically shortened at least four centimeters, and in the fourteenth patient (Case 13) pathological fracture of the femur as a result of a cyst had occurred. We regret that we were not able to use this nail to treat traumatic injuries of the femur. Because the nail has not been used in such injuries, this paper must be considered a preliminary report. Further study is needed to determine the wider indications for the nail.

In the first four patients in our series, healing has occurred and the nail has been removed, while in the remaining patients healing is progressing satisfactorily and there have been no secondary complications. In all our patients penicillin was used both before and after the operation. Blood transfusions were necessary in only one patient (Case 13). In this case two transfusions of 250 cubic centimeters each were given eight and ten days after the operation; as a result of this treatment, the postoperative anaemia was controlled. As regards the dimensions of the nails, we used the nail with a diameter of ten millimeters in all the patients but two; in these two patients (Cases 10 and 14) we used a nail with a diameter of twelve millimeters. It seems that nails of either of these two diameters will be adequate in most cases. A greater variety in length of the nail is necessary, however, especially of the central nail. Before the operation we tried to estimate, by study of the roentgenograms, the appropriate dimensions of the nail to be used.

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