We treated forty-eight femoral-shaft fractures in forty-seven patients
with the Grosse-Kempf interlocking intramedullary nail. Fifteen fractures
were transverse or short oblique, ten were long oblique or spiral, and
twenty-three were comminuted. Only twenty-four (50 per cent) of the
fractures were located in the middle one-third of the shaft. The median
time until full weight-bearing was thirty days (range, seven to 150 days).
Radiographic consolidation was seen in all fractures at a median of sixteen
weeks (range, nine to fifty-six weeks). The patients were followed for one
to four years, and no infections developed. The results in thirty fractures
were classified as excellent; in eight, as good; in seven, as fair; and in
two, as poor. We have found the Grosse-Kempf method to be useful in
treating patients with high-energy fractures, multiple injuries, open
fractures, and osteoporosis. Since there is a risk of rotational and
longitudinal instability with the dynamic method of interlocking nailing,
we recommend that the static method be used whenever there is doubt about
the stability of the fracture. We did not observe any delay in bone-healing
when the static method was used.