Open interlocking nailing of the fracture of the shaft of femur

Abstract

Fracture neck of femur has always attracted the mankind due to its peculiar nature of going into non union and osteonecrosis of femoral head even with best fixation method and adequate reduction. A novel way to treat fracture neck of femur is with small diameter dynamic hip screw and an additional derotation screw. 30 patients aged 18-60 years presenting to Deen Dayal Upadhyay Hospital with fresh (<3 weeks old) fracture neck of femur were randomized into two groups and were treated with two different modalities of fixation: Small diameter sliding hip screw and plate with an additional derotation screw (Mini DHS group) and three cannulated cancellous screws in an inverted triangle configuration (CCS group). Intraoperative duration of surgery and blood loss was noted. All the patients were followed up for a minimum period of 12 months. The clinical outcomes were evaluated using UCLA score. Postoperative radiographs were used to look for evidence of union, loss of the alignment of the fracture, trabecular continuity at fracture line, late segmental collapse and the presence of avascular necrosis. Between group comparisons were performed using chi square test and Student's T test. Conclusion: Small diameter dynamic hip screw with an additional derotation screw is a good method to treat fracture neck of femur with increased incidence of union and less complications.

Open Kuntscher Nailing of Femur Shaft Fracture- Its Relevance in Present Era of Interlock Nailing

“…While closed interlocking nail remains the gold standard in the treatment of femoral shaft fractures, open Kuntscher nailing may still have its relevance in the developing countries as reported by other author. 14,15 Maruenda-Paulino JI et al 16 after their study concluded usefulness of Kuntscher nailing in children and adolescents with unstable high velocity fracture of the femoral shafts. It was concluded that open Kuntscher nailing is a method still relevant in situations like poor patients, high risk patients and when interlocking nailing of femoral shaft fracture may not feasible.…”

Outcome of Open Reduction and Internal Fixation with Interlocking Intra-Medullary Nail in the Treatment of Fracture of Shaft of Femur without Fluoroscopy

“…Some Sha S et al authors advocate open nailing in the poly-trauma pa ent and first-trimester pregnant pa ent for the least radia on exposure because it requires no special equipment and achieves quick reduc on. ORIF is performed in certain situa ons like unavailability of C-arm fluoroscopy, trac on table, minimal resources, to avoid radia on hazards, early disposal of the pa ent, and overcrowded orthopedic 10,11 wards.…”