Prospective RCT across 7 Level 1 trauma centers randomizing 315 multiply injured patients with femoral shaft fractures to reamed vs. unreamed intramedullary nailing, with primary outcome of ARDS incidence. All fractures were nailed within 24 hours of injury. Directly challenges the concern raised by Pape et al. that reamed nailing increases pulmonary morbidity in polytrauma.
Prospective RCT across 7 Level 1 trauma centers randomizing 315 multiply injured patients with femoral shaft fractures to reamed vs. unreamed intramedullary nailing, with primary outcome of ARDS incidence. All fractures were nailed within 24 hours of injury. Directly challenges the concern raised by Pape et al. that reamed nailing increases pulmonary morbidity in polytrauma.