Surgical management of fracture shaft of femur with intramedullary interlocking nail
Journal Title: International Journal of Orthopaedics Sciences - Year 2018, Vol 4, Issue 4
Abstract
Background: Diaphyseal femur fractures, most often result from high-energy trauma, and must have high index of suspicion for complications. Currently surgery is indicated for most femur fractures because of high rate of union, low rate of complications and advantage of early stabilization which decreases the morbidity and mortality rate in patients. While the main stay of the treatment has been reamed interlocking intramedullary nailing. Methods: We studied a total of 40 patients (32(80%) male, 8(20%) Female) of fracture shaft of femur admitted in the Orthopaedic Department of Darbhanga Medical College & Hospital, Laheriasarai, Darbhanga treated with reamed femur intramedullary interlocking nailing. The common age group was ranging from 20 to 71 yrs (mean age - 36 yrs). 26(65%) patients had closed fracture, 10(25%) had Gustillo Anderson Grade I compound and 4(10%) had Grade II compound fracture. In 22(55%) patients fracture was at M/3rd, in 10 (25%) patients it was at L/3rd level and in 8(20%) patients it was at U/3rd level. 4(10%) patients were operated by open interlocking nail and other 36(90%) by closed technique using C-arm. Average Injury to surgery interval was 6.20 days. Results: Mean time for union was more in patients treated by open procedure (20 weeks) as compared to closed technique (18.35 weeks). 2 patients developed superficial infection, which healed completely and 2 patients developed deep infection with non-union. In our series of 40 patients, 24(60%) patients had excellent result, 12(30%) patients had good result, 2(5%) patients had fair result and 2 (5%) patients had poor result. Conclusions: Interlocking intramedullary nailing is a very effective and successful method of definitive primary treatment, in most types of fractures of the shaft of the femur. It provides strong fixation, rotational stability and earliest return to functional status, as the rate of healing is good with this method.
Authors and Affiliations
Dr. Rahul Kumar, Dr. Shailendra Kumar, Dr. Laljee Choudhry
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