DIAPHYSEAL FEMORAL FRACTURES

TREATMENT BY CLOSE V/S OPEN INTRAMEDULLARY INTERLOCKING NAIL

Abstract

Objectives: To assess the best results of diaphyseal femoral fractures treated
by closed intramedullary interlocking nail and open intramedullary interlocking nail. Study
Design: Cross sectional. Period: Jan 2009 to Jan 2011. Setting: LUH Jamshoro / Hyderabad.
Methods: Total 40 fractures of shaft of femur in 40 patients were treated with IMILN. All patients
have same post operative follow up. Early range of motion exercises of hip and knee joint was
started, pain management and 3rd generation cephalosporin intravenous antibiotics given for
5 days followed by oral antibiotics. Patients discharged as early as possible when patient’s
condition allowed and removal of stitches after two weeks. Patient’s assessment regarding
wound condition, range of movement of proximal and distal joints and fractures assessment
radiologically and clinically was done every month. Results: Majority of the cases were with
the age groups of 37.5% between 21-30 years. RTA was found most common 70% of the
cases. According to the AO classification oblique fractures were found most common 45%. On
the assessment of final results in both close and open methods, 5% infection found in close
method and 7.5% infection were in open method, less union time was found in closed group,
deformity was equally found in both groups and heeling time was also less found in closed
group. Conclusions: It is concluded that closed intramedullary interlocking nailing method is
the best procedure with excellent union for the femoral fracture.