The results of intramedullary nailing in open fractures due to firearm injuries

Background and aim: The aim of this study to determine the effects of fixation with intramedullary nails on union and the complications that develop in the early period in long bone fractures such as femur, tibia and humerus that develop after firearm injuries and to compare them ith alternative methods. Methods: In this study, we evaluated 89 patients who had open fractures after firearm injuries between 2008 and 2020, who applied to us and were fixed with intramedullary nails in a single session and continued their follow-up.89 of the major bone fractures, 48 were femoral, 34 were tiba and 7 of them were fractures of the humerus diaphysis. We examined these patients for union time, nonunion and development of infection. Results: Of the 48 femoral fractures included in the evaluation, infection occurred in 5 of them, osteomyelitis developed in 2 of these patients. The mean duration of union was 19 weeks. 3 patients had nonunion and 6 patients had delayed union. Among the 34 cases of open tibia fracture, 6 cases had varying degrees of infection, in 1 of them osteomyelitis developed. Mean union time was 22 weeks. Nonunion was observed in 3 cases and delayed union was observed in 5 cases. There were 7 cases of open humerus fractures. The mean time to union was 10.1 weeks. 1 patient developed superficial infection. We did not have any cases of nonunion or delayed union. Conclusion: Permanent intramedullary nail application after soft tissue healing after temporary fixation with debridement and external fixation in the first session is a generally accepted method. We believe that in selected cases, internal fixation with intramedullary nail can be applied in the first session with antibiotic prophylaxis and careful debridement. Keywords: Gunshot injury, open fracture, intramedullary nail, internal fixation.