Randomized controlled trial comparing open versus closed interlocking nail for closed fracture shaft of femur in Adults
Journal Title: International Journal of Orthopaedics Sciences - Year 2017, Vol 3, Issue 1
Abstract
Background: Close reduction and intramedullary fixation of fracture shaft femur proposed by Kuntscher, is the most biological way of treating the fracture shaft femur. But an open version of this procedure, by which the fracture is stabilized by opening the fracture site and fixing it by retrograde method, became popular because of less complication and more predictable operating time. With the development and emergence of image intensifier and modification in the technique, the locked intramedullary gained popularity. Locked intramedullary nailing can be inserted in a static or dynamic fashion. Aim and Objectives: To compare outcome of open versus closed interlocking nail for fracture shaft of femur in Adults in term of: union, Blood loss, infection rate, functional outcome, Complications if any. Methods and Materials: It is Randomised Controlled Trial Study. Randamization was done using Excel random number generation technique into two groups, each of size 40. Group A:- Diaphyseal fracture treated with closed methods. Group B:- Diaphyseal fracture treated with open methods. Sample size: 40 in each group Results: A total of 80 patients (49 male and 31 female) were included in the study. 15 patients were less than 25 years age group followed by 30 patients between 25-40 yrs, 25 patients between 41-60 age group and 10 patients more than 61 years. Road traffic accident is commonnest mode of injury followed by fall from height. The average blood loss is 119.5 ml in Closed nailing group and 139.5 ml in open nailing group. The procedure time is 71 mins in closed naililng group as comprared to 97 mins in open nailing group. Discussion: A total of 80 patients (49 male and 31 female) were included in the study. 15 patients were less than 25 years age group followed by 30 patients between 25-40 yrs, 25 patients between 41-60 age group and 10 patients more than 61 years. Road traffic accident is commonnest mode of injury followed by fall from height. The average blood loss is 119.5 ml in Closed nailing group and 139.5 ml in open nailing group. The procedure time is 71 mins in closed naililng group as comprared to 97 mins in open nailing group. Conclusion: Closed IMIL nailing group needs fracture table and image intensifier. Operating time and blood loss is more in Open nailing group. Cost of treatment and union is comparable in both groups. Infection is more in open group as compared to closed group.
Authors and Affiliations
Chaudhary P, Maharjan R, Kalawar RPS, Baral P, Shah AB
Open interlocking nailing of the fracture of the shaft of femur
Closed Interlocking intramedullary nails is now the standard in the treatment of femoral shaft fractures however use of traction table and image intensifier precludes its common use in developing countries. This study wa...
A two year follow up study of operative results of fractures of acetabulum
Aims & Objectives: To analyse the operative results of acetabulum fracture with respect to operative technique, clinical and radiological union, time for mobilisation, complications and functional outcome measured by Mer...
Functional outcome in metacarpal fractures treated with Minifragment plating
There is trend on rise to use miniplates over the kirschner’s wire for treating the fractures of hand. The improved system of internal fixation by miniplates has many advantages. The aim of the study was to evaluate whet...
To study epidemiological pattern and clinical and radiological parameters of recovery of septic arthritis in nfants and neonates admitted in B.R.D medical college, Gorakhpur
Introduction: Prior to the antibiotic era and more enlighten surgical approaches, the occurrence of septic arthritis presented literal threat to life and limb. Despite potent antibiotics, Septic arthritis continues to be...
Clinico- radiological evaluation of stand alone cage in degenerative cervical spine
Age-related cervical degeneration is evident in over 50% of the middle-aged population and is the most common cause of neural dysfunction. Cervical spine anteriorly stabilised by use of anterior cervical plate, strut gra...