Year: 2026 | Month: January-March | Volume: 11 | Issue: 1 | Pages: 79-89
DOI: https://doi.org/10.52403/ijshr.20260109
Surgical Management of Femoral Shaft Fractures: A Systematic Review
Angaj Skandh1, Ratnadip Sengupta2, TR Ramkumar3
1Senior Resident, Department of Orthopaedics, Agartala Government Medical College and GB Pant Hospital, Agartala, India.
2Post Graduate Trainee Final Year, Department of Orthopaedics, Agartala Government Medical College and GB Pant Hospital, Agartala, India.
3PG Resident, Department of Orthopaedics, Agartala Government Medical College and GB Pant Hospital, Agartala, India.
Corresponding Author: Dr. Angaj Skandh
ABSTRACT
Background: Intramedullary femoral nailing (IMN) is the gold standard for managing femoral shaft fractures. This systematic review aims to evaluate the current practices in the surgical management of femoral shaft fractures, focusing on the effectiveness of closed versus open reduction techniques.
Methods: This systematic review was conducted according to guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The literature search encompassed an extensive database including PubMed, ScienceDirect, Google Scholar, and Cochrane library. Studies published after the year 2013 were included in the analysis. The quality of the included studies was evaluated using the proper tools suited to the study design. The synthesis and analysis of data included a narrative summary of study characteristics, aims and objectives, surgical technique, and main study results/conclusions.
Results: Sample sizes in the selected studies ranged from 18 to 398 participants. The most common surgical techniques used for femoral shaft fractures were Closed and open intramedullary (IM) nailing. Generally, the studies found that closed techniques, such as closed nailing and closed reduction, had similar or better outcomes compared to open techniques in terms of union rates, blood loss, infection rates, and functional outcomes. Overall, the studies suggest that closed techniques and novel minimally invasive reduction methods can be effective alternatives to traditional open approaches for the treatment of femoral shaft fractures.
Conclusion: This systematic review concludes that closed reduction for intramedullary nailing of femoral shaft fractures is associated with better outcomes in terms of union rates and recovery times. Open reduction remains an acceptable alternative, particularly in challenging cases.
Keywords: Femoral shaft fractures, intramedullary nailing, closed and open intramedullary nailing, closed reduction, open reduction.