OUTCOMES IN CLOSED REAMED INTERLOCKING NAIL IN FRACTURES OF SHAFT OF FEMUR

Authors

  • Taj Mohammad Department of Orthopaedics, Ayub Medical College, Abbottabad
  • Alamzeb Sawati Department of Orthopaedics, Ayub Medical College, Abbottabad
  • Ashfaq Ahmed Department of Orthopaedics, Ayub Medical College, Abbottabad
  • Abdus Saboor Awan Department of Orthopaedics, Ayub Medical College, Abbottabad
  • Siddique Siddique Department of Orthopaedics, Ayub Medical College, Abbottabad

Abstract

Background: Femoral shaft fracture is one of the common fractures seen in accident and emergency department of our hospital. Violent forces are required to break this and strongest of human bones. There are various treatment modalities for femoral shaft fractures in adults like traction, brace, platting, intramedullary nail (IMN), external fixators and inter locking nails. The study was done with an objective to evaluate the results of closed reamed interlocking nail in fractures of shaft of femur. Methods: A prospective study of 114 cases of femoral shaft fractures was carried out at orthopaedic unit of Ayub Teaching Hospital Abbottabad during 1 year. All these cases were treated with statically locked nails under spinal or general anaesthesia. These cases were followed up for up to one year and Results of the interlocking nail were observed in terms of union and complications. Results:  Out of 114 patients, 95 underwent union in 90–150 days with a mean of 110.68 days. Ten patients had dynamization within six weeks because of obvious fracture gap in radiograph. There were 3 patients who had non-union, and 6 patients had delayed union which was treated with dynamization. Conclusion: Close reamed interlocking intramedullary nail in femoral shaft fractures is the treatment of choice. Patient rehabilitation is early, hospitalization is short, and fracture healing response is good.

References

Ellis H. In: Clinical anatomy, a revision and applied anatomy for clinical students. 11th edition Oxford: Blackwell Scientific Publications 2004;223.

Gharehdaghi M, Rahimi H, Bahari M, Afzali J. A prospective study of closed and open reamed intramedullary nailing of 136 femoral shaft fracturesin adults. J Res Med Sci 2007;12:16–20.

Chen CE, Weng LH, Ko JY, Wing CJ. Management of Nonunion Associated With Broken Intramedullary Nail of the Femur. Orthopedics 2008;31(1):78.

Lundy D, Johnson KD. “Floating Knee” Injuries: Ipsilateral Fractures of the Femur and Tibia. J Am Acad Orthop Surg 2001;9(4):238–45.

Nowotarski PJ, Turen CH, Brumback RJ, Scarboro JM. Conversion of External fixation to Intramedullary Nailing for Fractures of the Shaft of the Femur in Multiply Injured Patients. J Bone Joint Surg Am 2000;82(6):781–8.

Shrestha B, Kumar P, Singh GK. Comparative study of management of closed comminuted femoral shaft fractures with closed interlocking intramedullar nail and open reduction and dynamic compression bridge plating. J Nepal Med Assoc 2004;43:239–43.

Atiq G, Satar A, Inam M. Treatment of long bones fractures with surgical implant generation network (SIGN) nail. RMJ 2012;37(2):176–8.

Tornetta P 3rd, Tiburzi D. Antegrade or reterogade reamed femoral nailing: A prospective randomized trial. J Bone Joint Surg Br 2000;82(5):652–4.

Rehman A, Laghari A. Fracture of femoral neck during intramedullary nailing of the femur. J Surg Pak 2001;6(2):42–3.

10 Sié EJB, Kacou AD, Traoré A, Séry BL, Lambin Y. Primary Unreamed and Unlocked Intramedullary Nailing of Femoral Shaft Fractures. Malays Orthop J 2012;6(3):13–7.

Kasturi A, Srinivasan N, Arvind B, Kiran M, Veerasi E. A study of closed interlocking nailing for fractures of shaft of femur in adults”. J Evol Med Dent Sci 2013;l2(24):4469–80.

Giannocdis PV, MacDonald DA, Matthews SJ, Smith RM, Furlong AJ, DeBoer P. Nonunion of femoral diaphysis. The influence of Reaming and non-steroidal anti-inflammatory drugs. J Bone Joint Surg Br 2000;82(5):655–8.

Nowotarski PJ, Turen CH, Brumback RJ, Scarboro JM. Conversion of External fixation to Intramedullary Nailing for Fractures of the Shaft of the Femur in Multiply Injured Patients. J Bone Joint Surg Am 2000;82(6):781–8.

Gupta SKV, Govindappa CVS, Yalamanchili RK. Outcome of retrograde intramedullary nailing and locking compression plating of distal femoral fractures in adults. OA Orthopaedics 2013;1(3):23.

Wu C-C. Retrograde traditional femoral or tibial locked intramedullary nails for distal femoral injuries. Formos J Musculoskelet Disord 2012;3(3):77–82.

Umer M, Niazi AK, Hussain D, Ahmad M. Treatment of acute fractures of the Femoral Shaft with reamed Intramedullary Interlocking AO Nails. J Pak Med Assoc 2004;54(8)423–7.

Giri SK, Adhikari BR, Gurung GB, RC D, Bajracharya AR, Khatri K. Mini-open reduction and intramedullary interlocking, nailing of fracture shaft of femur without an image intensifier. Nepal Med Coll J 2008;10(2):123–12.

Soni RK, Mehta SM, Awasthi B, Singh JL, Kumar A, Thakur L, et al. Radiation-free insertion of distal interlocking screw in tibial and femur nailing: A Simple Technique. J Surg Tech Case Rep 2012;4(1):15–8.

Singh I, Vasudeva N, Mishra S. Inderbir Singh’s textbook of human histology: with colour atlas and practical guide. 7th edition. New Delhi Philadelphia: Jaypee, The Health Sciences Publishers; 2014. p.439.

Afsar SS, Gulzar M, Babar IU. A one year review of various complications in fracture shaft of femur managed with closed intramedullary interlocking nail. J Postgrad Med Inst 2013;27(3):336–41.

Kao HK, Wu CC, Lee PC, Su CY, Fan KF, Tseng IC. Ipsilateral Femoral Neck and Shaft Fractures Treated with Russell-Taylor Reconstruction Intramedullary Nails. Chang Gung Med J 2006;29(1):79–85.

Karuppiah, SV, Johnstone AJ. Distal locking in femoral intramedullary nailing system: J Biomed Sci Eng 2012;5(10):593–6.

Patton JT, Cook RE, Adams CI, Robinson CM. Late fracture of the hip after reamed intramedullary nailing of the femur. J Bone Joint Surg Br 2000;83(7):967–71.

Published

2015-12-15

Issue

Vol. 27 No. 4 (2015): Journal of Ayub Medical College, Abbottabad

Section

ORIGINAL ARTICLE

License

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.

Most read articles by the same author(s)

1 2 3 > >>