The Marchetti bundle nail for femoral shaft fractures: a review of 56 cases

The aim of this retrospective study of 56 cases was to determine the risks and the limits of the Marchetti bundle nail in the treatment of femoral shaft fractures. According to the AO classification, 25 fractures were in category A, 20 in category B, 7 in category C and 4 were distal metaphysio-diaphyseal fractures with intercondylar separation classified as 33C2. Intraoperative complications were not directly related to the type of nail. Postoperative complications included nonunion, delayed union, malunion such as axial deformity, and shortening. We conclude that the Marchetti bundle nail is a successful method for the treatment of femoral shaft fractures taking into consideration the short operation time, the efficacy of distal locking and the lack of preliminary reaming. Moreover it is clear that our results were prejudiced due to our learning experience with this new implant. Proximal locking should only be carried out when indicated, in order to prevent delayed union. If may be combined with inter-fragmental screw fixation, and this is useful in the treatment of complex supracondylar fractures.