Intramedullary nailing is an accepted procedures for @entity3330 gives uniformly good results. Various methods of intramedullary fixation have been practiced in the past. Recently intramedullary fixation without reaming has come into vogue. Preservation of the endosteal blood supply, less @entity190 and quicker union have been the alleged benefits of not reaming the medullary canal. This study is a prospective randomised study conducted to compare intramedullary nail fixation of closed @entity3330 with and without a reaming procedure to assess the validity of the above assumptions. One hundred and two consecutive cases of skeletally mature @entity1 with closed fracture of femoral shaft were randomised into two groups, i.e. Reamed (52) and Unreamed (50). The average follow-up was 36 weeks (range 28-86 weeks). Average time taken for various stages of the operation and total operating time were longer in the reamed group (109.9 min vs 78.6 min) and the @entity190 was also increased (320 mls vs. 190 mls). Bridging and callus formation were seen to occur earlier in the reamed group compared to the unreamed enabling the @entity1 in the reamed group to return to normal functions earlier. Limb length discrepancy and rotational alignment measured clinically and with CT scan did not however show any significant difference between the two methods. Nails used in this study group were notably of a smaller diameter and of shorter length when compared to those used in the western population highlighting the difference in the femur in the Asian population. Complications were notably more in the unreamed group where these were screw breakage (3/50) delayed unions (9/50) and non-unions (4/50). In the reamed group however there were only delayed union (2/50) and all @entity174 eventually united without any implant failure. We conclude that closed, reamed, antegrade insertion of an intramedullary nail is the treatment of choice in femoral shaft @entity174 , especially those involving the distal 1/3. The unreamed procedure should be reserved for certain exceptions, such as in polytrauma, where a shorter operative time and less @entity190 is desired.

Comparison study between reamed and unreamed nailing of closed XXXX .

@entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity3330 :: ('MESH:D005264', 'Disease') :: ['femoral fractures'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures']
@entity3330 :: (MESH:D005264,Disease) :: ['femoral fractures']
