Unreamed intramedullary nailing of femoral shaft fractures using a traction device.

The authors present a simple distraction apparatus that is used in the sterile field and makes it possible to perform unreamed intramedullary nailing of the femur on a normal operation table. Intramedullary (IM) nails were placed, without reaming, in 24 femoral shaft fractures with the use of this device. Although it appears as though the use of the distractor did not lengthen the operative procedure, the set-up time was 60 per cent less compared with a stratified group of 28 femoral nailing using the fracture table. We feel that this device provides a safe and effective means for achieving fracture reduction without the need for a fracture table. It is especially useful in the multiply injured patient where the additional lesions can be treated without the need for patient transfer to the fracture table.