The Grosse-Kempf Nail for Femoral Fractures: A Review of 439 Cases

Abstract

Intramedullary nailing using the Grosse-Kempf device was performed in 439 patients with fractures of the femoral shaft between 1982 and 1997 in Gregorio Marañón Hospital. The average age of the patients was 39 years. A traffic accident was the most frequent aetiology in young patients and an accidental fall or a pathological fracture in those older than 60 years. The most common location was the distal third of the femoral diaphysis, with oblique and transverse fractures being the most common patterns. The nail assembly was static, proximally dynamic or distally dynamic in 62 %, 24 % and 14 % of the cases, respectively. The most frequently used diameter and length were 12 mm and 380 mm. Consolidation was achieved at an average of 17 weeks. The most frequent complications were non-union (8 cases), failure of the implant (8 cases) and deep infection (7 cases). The results were considered good or excellent in more than 90 % of the cases. The intramedullary locking nail remains the treatment of choice for diaphyseal femoral fractures. A profound knowledge of the care for polytraumatised patients and experience with intramedullary nailing are required to improve results and to minimise complications.

Endomedullary nailing - Grosse-Kempf nail - polytrauma

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