Ten years' experience with femoral shaft fractures.

One hundred one patients with femoral shaft fractures treated by open reduction and intramedullary fixation have been presented. The results demonstrated no nonunions in nonpathologic bone; less than 2% infection; clinical union in 4 to 6 months; radiologic union at 6 to 8 months; excellent range of knee motion in more than 90% of patients; unsupported full weight-bearing usually present by the eighth postoperative week, and an average hospital stay of 6 to 7 weeks. The advantages and disadvantages of the most common methods of treatment of femoral shaft fractures have been reviewed. The non-operative approach of cast-bracing has yielded encouraging results in the hands of those well-trained in its application. Weighing the advantages and disadvantages of the operative and nonoperative techniques, as described, we feel that open reduction and internal fixation with an intramedullary rod is still the treatment of choice for most femoral shaft fractures, in the hands of most orthopaedic surgeons.