Why the study?
Does intramedullary nailing with reaming cause harmful systemic effects in patients with femoral diaphyseal fractures?
Does intramedullary nailing with reaming cause harmful systemic effects in patients with femoral diaphyseal fractures?
This review emphasizes the need to consider the potential harmful systemic effects, such as lung inflammation and fat embolization, when using intramedullary reaming for femoral fracture fixation in trauma patients.
Raises caution for pulmonary risks with reamed femoral nailing; leaves open optimal technique pending prospective trials.
Intramedullary nailing is the preferred treatment for stabilizing femoral diaphyseal fractures. Despite the superior biomechanical advantages over other implants, its use especially in some selected groups of patients, has been questioned because of possible harmful systemic effects of intramedullary reaming. The lung seems to be the primary target for fat embolization and for mediated effects by inflammatory reactions. The latter are initiated in the immediate aftermath after injury, and femoral nailing can amplify these responses. The role of reaming in the context of early femoral fracture fixation in the patient experiencing trauma is debatable. This review article focuses on the evidence that has emerged during the past century regarding the systemic effects of femoral nailing.
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Giannoudis et al. (2002) studied this question.
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