Intramedullary Nailing of Femoral Shaft Fractures Using the Hansen-Street Nail

This is a retrospective study of 211 consecutive femoral shaft fractures treated with intramedullary nailing using the solid, diamond-shaped Hansen-Street nail. The pre-bent nail was inserted into the broached femoral canal with the aid of image fluoroscopy and with closed reduction in 168 cases, with an average operating time of 1.7 h and blood loss of 75 cc. Open technique was performed in 43 cases. The average follow-up was 13.7 months; there were no nonunions. The time to bony union by bridging callus was 4.1 months. Length stability correlated with the degree of comminution and the fracture site location. Shortening greater than 2 cm was found in 1.4% of the cases. Malrotation greater than 10 deg occurred in 2.1% and infection in 1.8% of patients. The Hansen-Street nail provides a simple and versatile bone-implant complex and is somewhat unique in affording some rotational control by the press fit of the diamond-shaped nail in the prebroached medullary canal. This end-result study reveals gratifying clinical results without sacrificing the medullary contents and some endosteal cortex, which results from intramedullary reaming.