Management of Infection after Femoral Küntscher Nailing

Intramedullary nailing of the fractured femur is a well accepted form of treatment and has obvious advantages, but the post operative infection is an ever present threat and a disastrous complication. The purpose of this article is to report the result of 4 patients treated in our orthopedie department and to review recent literatures. Infection complicating intramedullary nailing of the femur is more common in open than closed fractures and is more likely to occur in patients who sustain multiple trauma, The delay in hospitalization before surgery is accompanied by a proportionate rise in postoperative infection and this may be the important factor in the high incidence of Infection in multiple trauma. Therefore, it was emphasised that if fractures of the femur are to be treated by intramedullary nailing, the surgery should be done as soon as possible after the patient is admitted to the hospital. The open fractures may be treated by early debridement. high antibiotics and balanced traction if possible. Once infection has developed the nail should be retained until secure union has occurred and carefully planned surgery with meticulous debridement of all scar tissues and dead bones, followed by closure of the wound over a closed suction antibiotic irrigation system is considered the best treatment.