The Clinical Efficacy and Safety of Intramedullary Nailing for Traumatic Fractures of the Femur and Tibia: A Retrospective Cohort Study

Intramedullary nailing is the standard for stabilizing femoral and tibial diaphyseal fractures. This study evaluated its effectiveness and safety in adults with traumatic long-bone injuries. Methods: Retrospective cohort of adult inpatients treated at a single center (January 2021–July 2024). Demographics, fracture features, intraoperative variables, and outcomes were extracted from electronic records. Primary endpoints were 6-month radiographic union and overall postoperative complications. Secondary endpoints included time to union, time to full weight-bearing, 12-month Lower Extremity Functional Scale (LEFS), and specific complications. Results: A total of 100 patients (65 males and 35 females) with 155 fractures (85 femoral and 70 tibial) were analyzed. Union at 6 months was achieved in 145/155 fractures (93.5%); mean time to union was 16.8±4.5 weeks. Overall complications occurred in 25/155 fractures (16.1%), most commonly delayed union (5.2%), superficial infection (3.9%), and malunion (3.2%); deep infection occurred in 1.9%. The mean 12-month LEFS was 70.5±9.8. Conclusion: Intramedullary nailing yields high union rates, acceptable complication profiles, and good functional recovery in femoral and tibial shaft fractures, supporting its continued use as standard care.