Fifty-six patients who had a fracture of the femur due to a low-velocity
gunshot injury were treated with interlocking nailing with the Grosse-Kempf
nail. Patients who had an isolated fracture were treated by intravenous
administration of antibiotics followed by delayed interlocking nailing.
Ninety-three per cent of the fractures had Grade-III or IV comminution. At
an average duration of follow-up of sixteen months (range, twelve to
twenty-nine months), the results of closed interlocking nailing were
excellent. All of the fractures united an average of twenty-three weeks
(range, fourteen to forty weeks) after the nailing. There were no apparent
infections in the entire series. There were two delayed unions and seven
malunions. Five patients had a serious associated vascular injury; four of
these five had interlocking nailing immediately after vascular repair. The
fractures united without any residual vascular insufficiency.