[The AO universal femur intramedullary nail: problems and their amelioration. Retrospective quality control study of 57 femur shaft fractures].

Today intramedullary nailing is considered the treatment method of choice in fractures of the femoral diaphysis. In this retrospective quality control study 57 femoral fractures treated with the AO-Universal Femoral Nail have been reviewed. The average follow up time was 2.9 years. Intramedullary nailing was done as a primary procedure in 40 cases and in 17 cases as a secondary procedure following various initial operations. The results were evaluated according to the Stromsoe score. 27 of the 40 primary procedures went on to an uneventful healing and showed good to excellent final result. Technical errors (7), non-unions (4) and 1 deep infection required various secondary procedures. Thereafter the final number of good to excellent results amounted to 35 out of 40 patients. In the group with secondary i.m. nailing 9 out of 17 patients showed a good to excellent final result. 2 non unions persisted. In conclusion the AO-Universal Femoral Nail proved to be suited for the treatment of femoral shaft fractures for both primary and secondary procedures. In this series, however, technical imperfections led to a high rate of secondary procedures. Strict observation of the recommended operative technique is therefore mandatory.