Intramedullary nailing of multiple long-bone fractures of the lower extremity at the same surgery: a single-center experience

We evaluated the outcome of multiple intramedullary nailing at the same surgery for traumatic long-bone fractures. All but 2 of 27 patients (average age 40) had been involved in motor vehicle accidents, and 17 of them presented with other associated nonorthopedic injuries. Ten patients had open fractures. Sixty-one nails were used. The average time from accident to fixation was 8.16 h, and the average time in the operating room was 5.4 h. No patients died; all required blood transfusion; and eight patients were admitted for at least 24 h to the intensive care unit. The average hospital stay was 27 days, the mean time to full weight-bearing was 4 months, and the average time to radiographic healing was 7.5 months. Three patients required dynamization to achieve fracture union; three underwent exchange nailing for nonunion and one for nail breakage. Thus, early fixation of multiple long-bone fractures by intramedullary nailing in polytrauma patients is an acceptable treatment method.