Two-Plane Fixation in Fractures of the Femoral Shaft

Arch Surg. 1961;82(4):592-598. doi:10.1001/archsurg.1961.01300100106012.
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The treatment of fractures of the shaft of the femur in the adult by traction alone has gradually given way to treatment by open reduction and internal fixation because the latter method assures more accurate apposition of fragments and, if the fixation is secure, shortens the period of confinement. It is recognized, however, that for internal fixation of fractures of the shaft of the femur, the fixing device must give sufficient stability to overcome the powerful deforming forces created by the musculature or it must be considered merely as an appositional device to be augmented by efficient external support. The intramedullary nail has proved to be a satisfactory device for fixation of selected fractures occurring in the isthmus, or narrow portion, of the femur; but for comminuted or otherwise complicated fractures occurring at this level or for fractures occurring at other levels, a nail is not always adequate, and internal


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