Abstract：
BACKGROUND: This study aims to determine whether nail size or the difference between canal and nail diameter (CN difference) affects the union rate and time of femoral shaft fracture treated with an interlocking intramedullary nail (IMN).
METHODS: This was a retrospective review of 257 patients with femoral shaft fractures treated with IMN at a tertiary trauma medical center. All the IMN inserted were the same (Stryker T2 Femoral Nail). The patients were divided into groups based on nail size (10-, 11-, 12-, or 13-mm) and CN difference (< 1, 1-2, or > 2 mm), and union rate and time to union were compared.
RESULTS: The 10-, 11-, 12-, and 13-mm groups based on nail size had 113, 74, 54, and 16 patients, respectively. The overall union rate was 97% (257/265). No significant differences in union rate or time to union were observed among these 4 groups. The groups based on CN differences of < 1-, 1 to 2, and > 2 mm comprised 143, 79, and 35 patients, respectively. Again, no significant differences were noted in union rate or mean time to union among the groups.
CONCLUSIONS: Similar union rate and time to union were observed, regardless of nail size or CN difference. This finding indicates that most simple femoral shaft fractures can be treated with a standard, reamed 10-mm IMN. A larger nail insertion is unnecessary and presents more risks; comparatively, the use of a small nail with less reaming is simpler, requires shorter operative times, results in less blood loss, and is less expensive.
METHODS: This was a retrospective review of 257 patients with femoral shaft fractures treated with IMN at a tertiary trauma medical center. All the IMN inserted were the same (Stryker T2 Femoral Nail). The patients were divided into groups based on nail size (10-, 11-, 12-, or 13-mm) and CN difference (< 1, 1-2, or > 2 mm), and union rate and time to union were compared.
RESULTS: The 10-, 11-, 12-, and 13-mm groups based on nail size had 113, 74, 54, and 16 patients, respectively. The overall union rate was 97% (257/265). No significant differences in union rate or time to union were observed among these 4 groups. The groups based on CN differences of < 1-, 1 to 2, and > 2 mm comprised 143, 79, and 35 patients, respectively. Again, no significant differences were noted in union rate or mean time to union among the groups.
CONCLUSIONS: Similar union rate and time to union were observed, regardless of nail size or CN difference. This finding indicates that most simple femoral shaft fractures can be treated with a standard, reamed 10-mm IMN. A larger nail insertion is unnecessary and presents more risks; comparatively, the use of a small nail with less reaming is simpler, requires shorter operative times, results in less blood loss, and is less expensive.
摘要：
背景：本研究旨在确定钉的大小或管和钉直径之间的差异（CN差异）是否会影响带锁髓内钉（IMN）治疗股骨干骨折的愈合率和时间。
方法：本研究是对在三级创伤医疗中心接受IMN治疗的257例股骨干骨折患者的回顾性研究。所有插入的IMN均相同（StrykerT2股骨钉）。根据指甲大小将患者分为几组（10-，11-，12-，或13毫米)和CN差异(<1、1-2或>2毫米)，比较了工会率和工会时间。
结果：10-，11-，12-，根据指甲大小，13毫米组有113、74、54和16名患者，分别。总体结合率为97%(257/265)。在这4组之间，未观察到愈合率或愈合时间的显着差异。基于<1-的CN差异的组，1至2毫米，>2毫米，包括143、79和35名患者，分别。再一次,各组间的工会率或平均工会时间无显著差异.
结论：观察到相似的愈合率和愈合时间，无论指甲大小或CN的差异。这一发现表明，大多数简单的股骨干骨折可以用标准的治疗，扩孔10毫米IMN。较大的指甲插入是不必要的，并且存在更多风险；相对而言，使用扩孔少的小钉子更简单，需要更短的手术时间，减少失血，而且更便宜。
方法：本研究是对在三级创伤医疗中心接受IMN治疗的257例股骨干骨折患者的回顾性研究。所有插入的IMN均相同（StrykerT2股骨钉）。根据指甲大小将患者分为几组（10-，11-，12-，或13毫米)和CN差异(<1、1-2或>2毫米)，比较了工会率和工会时间。
结果：10-，11-，12-，根据指甲大小，13毫米组有113、74、54和16名患者，分别。总体结合率为97%(257/265)。在这4组之间，未观察到愈合率或愈合时间的显着差异。基于<1-的CN差异的组，1至2毫米，>2毫米，包括143、79和35名患者，分别。再一次,各组间的工会率或平均工会时间无显著差异.
结论：观察到相似的愈合率和愈合时间，无论指甲大小或CN的差异。这一发现表明，大多数简单的股骨干骨折可以用标准的治疗，扩孔10毫米IMN。较大的指甲插入是不必要的，并且存在更多风险；相对而言，使用扩孔少的小钉子更简单，需要更短的手术时间，减少失血，而且更便宜。
