A. M. Ilias Basha, K. B. Vijayamohan Reddy, Prasad Divvela
BACKGROUND
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. The main stay of the treatment has been reamed interlocking intramedullary nailing, one of the frequently performed procedure for diaphyseal fracture of femur.
MATERIALS AND METHODS
We studied a total of 40 patients of fracture shaft of femur admitted in the Orthopaedic Department of Government General Hospital, Kurnool, treated with reamed femur intramedullary interlocking nailing. The common age group was ranging from 20 to 71 yrs. with average age group of 36 yrs. 32 patients were males, 8 were females. 26 patients had closed fracture, 10 had Gustillo Anderson Grade I compound and 4 had Grade II compound fracture. In 22 patients fracture was at M/3rd, in 10 patients it was at L/3rd level and in 8 patients it was at U/3rd level. 4 patients were operated by open interlocking nail and other 36 by closed technique using C-arm.
RESULTS
Injury surgery interval was 6.20 days on an average. Mean time for union was more in patients treated by open procedure (20 weeks) as compared to closed technique (18.35 weeks). We found 2 patients developed superficial infection, which healed completely and 2 had deep infection with nonunion. In our series of 40 patients, 24 patients had excellent results, 12 patients had good results, 2 fair results and 2 poor results, and functional evaluation was done using Thoresen et al classification system.
CONCLUSION
nterlocking intramedullary nailing is a very effective and successful method of definitive treatment in most types of fractures of the shaft of the femur. It is effective in controlling rotational and longitudinal forces that act across the fracture site. Interlocking nail provides strong fixation, rotational stability and earliest return to functional status, as the rate of healing is good with this method. It allows early weight bearing and reduced rehabilitation.
