Since May 1972, the standard treatment of femoral shaft fractures at the
Western General Hospital has been the closed femoral nailing technique of
Kuntscher. We have found that the use of intraoperative skeletal traction
eliminates the need for immediate operation, preoperative skeletal
traction, or the use of a distraction apparatus to prevent preoperative
shortening. By the use of a cross-pinning technique, the closed femoral
nailing method has been extended to include severely comminuted fractures
of the femoral shaft and fractures of the distal third of the femur, with
effective control of shortening and rotatory deformity. This allows early
mobilization and discharge from the hospital for patients with these
difficult fractures. One hundred and twelve consecutive traumatic fractures
of the femoral shaft treated in this manner united within three to six
months. The clinical results in terms of early joint movement, early
weight-bearing, and rapid discharge from the hospital have been
excellent.