A Prospective Study of Surgical Management of Fracture Shaft Femur With Closed Intramedullary Interlocking Nail.

Abstract

HOW TO CITE THIS ARTICLE:Mahendranath Reddy D, Muralidhar BM. "A prospective study of surgical management of fracture shaft femur with closed intramedullary interlocking nail". Journal of Evolution of Medical and Dental Sciences 2013; Vol. 2, Issue 47, November 25; Page: 9098-9105. ABSTRACT: Orthopaedic surgeons often encounter diaphyseal femur fractures, because these fracture most often result from high-energy trauma, one 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. The present study is hospital based prospective study of 40 adult patients admitted in SSMC Hospital, TUMKUR between October 2010 -March 2012 and cases were followed regularly. The common age group involved was from 18-65 yrs. with mean age of 33.5, 36 patients were males, 4 were females. 16 fractures were on right side, 24 were on left side. Two (5%) fractures was in proximal third, 26 (65%) were in the middle third and 12 (30%) were in the lower third. Surgery was done at an average 3 days ranging from 2 -5 days. Duration of hospital stay was 12 days ranging from 10-15 days. Mean time for union was 20 weeks. There was one case of distal bolt backing out and there were three cases of superficial infection. Excellent to good result were seen in 75% of cases. INTRODUCTION:Orthopaedic surgeons often encounter diaphyseal femur fractures because these fractures most often result from high energy trauma, one must have a high index of suspicion for complications or other injuries. Advance in mechanization and acceleration of travel have been accompanied by increase in the number and severity of the fracture. Fracture femur results from the drawbacks of fast life and violence and are major source of mortality and morbidity in patients with such injury. The art of femoral fracture care is a constant balancing of the often-conflicting goals of anatomical alignment and early functional rehabilitation of limb.Closed nailing causes no damage to extra periosteal soft tissues and the biological environment round the fracture is least disturbed. Another important feature of the closed intramedullary interlocking nail is the chance for early ambulation of the patient which reduces the complications of prolonged bed ridden patient.Comminuted and segmental fractures of femoral diaphysis are often difficult to treat. When intermediate fragment is split or there is comminution of either level of segmental fracture, the interlocking nail is the only best available implant, since the conventional IM nailing does not provide adequate fixation.Proximal & Distal shaft fractures where one cannot get three point fixations can also be stabilized by use of interlocking nails. Intramedullary nail being close to centre of femur can tolerate bending and torsional loads be...