INTRAMEDULLARY INTERLOCKING NAILING WITHOUT IMAGE INTENSIFIER AND ORTHO TABLE

Abstract

Interlocking nails are the gold standard treatment of fractures of shaft of long bones of lower limbs. It is also frequently performed
for most of the humerus fractures. The procedure is commonly performed using an image intensifier and orthotable. These are expensive and
are not readily available in peripheral/field hospitals especially in resource – poor countries. Design: Retrospective study. Setting: Field
Hospital Muzaffarabad and Combined Hospital Kharian. Period: Sep 2007 to July 2011. Patients & Methods: 138 consecutive cases of
fractures of femur, tibia and humerus shafts fixed with I/M I/L Nails in a field hospital. Reduction was achieved by open method in 87 (96.66%)
cases of femur, 24 (60%) case of tibia and 5(62.5%) of humerus. Results: There were 34 females and 100 males’ ratio 1:2.94. All the cases were
adults with mean age 38.2 years and range was 16-78 years. Bones fixed were femur (90) 65.21%, tibia (40) 28.21%, and humerus (8) 5.70%.
Fracture line was transverse in 104 (75.3%) and communited 10 (7.2%). Fractures were closed 112 (81.2%) and 26 (18.8%) of case. Recent
fractures were 122 (88.4%) and old non united 16 (11.6%). Mean follow up period was 06 months - range 3 months to 1 ½ years. Complications
were failure to achieve distal interlocking 6 cases, infection 3 cases. Union time averaged 3.5 months. Conclusions: It is therefore concluded
that I/M I/L nailing can be done without image and traction table.