Retrospective cohort of 211 intramedullary nailing cases (femur, tibia, humerus) over five years, using multiple logistic regression to identify which pre- and perioperative factors independently predict deep infection and nonunion — addressing a question with limited high-quality RCT data at the time of publication.
When planning IM nailing, flag open fractures and high ASA scores upfront — these independently drive infection and nonunion risk, respectively.
Avoid opening the fracture site during surgery whenever possible, and ensure experienced surgeon oversight to keep operative time reasonable, as prolonged cases in open fractures compound infection risk substantially.
Retrospective cohort of 211 intramedullary nailing cases (femur, tibia, humerus) over five years, using multiple logistic regression to identify which pre- and perioperative factors independently predict deep infection and nonunion — addressing a question with limited high-quality RCT data at the time of publication.
When planning IM nailing, flag open fractures and high ASA scores upfront — these independently drive infection and nonunion risk, respectively.
Avoid opening the fracture site during surgery whenever possible, and ensure experienced surgeon oversight to keep operative time reasonable, as prolonged cases in open fractures compound infection risk substantially.