Expeditious femoral nailing prior to vascular repair in fractures associated with vascular injury: A series of four cases.

Abstract

Femoral shaft fractures with concomitant vascular injury requiring limb revascularization, although rare, are a limb-threatening condition. Historically, emergent external fixation of the femur fracture followed by vascular repair has been considered the standard of care. We discuss four cases of femoral fracture with an associated vascular injury amenable to nail fixation stabilized by expeditious intramedullary nailing (IMN), followed by limb revascularization. We discuss the timeline and duration of the procedure for this technique. Expeditious femoral IMN prior to limb revascularization has multiple clinical advantages and has become our standard protocol for these injuries.