[Use of a Russel-Taylor nail for stabilizing fractures of the femur. Apropos of 57 fractures with 30 computed tomographies of the rotation]. / Utilisation d'un clou non fendu de Russel-Taylor pour la stabilisation des fractures du fémur. A propos de 57 fractures avec 30 études tomodensitométriques de la rotation.

PURPOSE OF THE STUDY: A clinical and radiographical study with CT in 30 cases was undertaken in femoral fractures fixed with Russel-Taylor intramedullary nail. MATERIAL AND METHODS: In this retrospective study of 57 femoral fractures (mean follow-up 22 months), all fractures were analysed according to the classification of Wiss and Winquist-Hansen-Clawson. Fixation was performed with Russel-Taylor intramedullary mailing. Fifty fractures were classified as unstable due to the type of fracture and for its localization. Analysis of the clinical and radiographical results was performed immediately postoperatively and later by CT (30 cases). RESULTS: Clinical results showed seven cases of hip pain and limited walking capability; twenty with decreased hip mobility; twenty-one with functional impairment of the knee with limited flexion (11 cases) and/or knee sprain (15 cases). Radiographical results showed sixteen cases of leg shortening inferior to 1 cm, three between 1 and 2 cm, and one exceeded 2 cm; nine with varus angulation of 5 degrees, one with valgus angulation of 5 degrees, and seven with external rotation exceeding 10 degrees, five with internal rotation exceeding 10 degrees. Results were determined according to Thorensen's criteria. DISCUSSION: The use of Russel-Taylor intramedullary nail for the management of complex femoral fractures is discussed. Rotational deformities appeared related to the quality of reduction during surgery. Because of the stiffness of this type of nail, a smaller diameter can be used. Result analysis demonstrates that static nailing should probably be used more frequently in unstable femoral fractures.