Supantha Panja1
BACKGROUND
Femoral shaft fractures result from high energy trauma and maybe associated with
life threatening conditions. Typical in younger people is associated with
polytrauma. Though intramedullary nailing (IMN) is the gold standard option of
treatment, external fixation (EF) can also be used temporarily or definitively, in
such cases. The aim of this study was to compare the functional outcome of these
two procedures.
METHODS
This prospective comparative study was conducted at our centre over a period of
6 years. Age, sex of the patients, laterality, type of fracture with mean follow up,
union time, and complications such as delayed union, angular deformities, and
limb length discrepancies were tabulated and compared.
RESULTS
There were more cases of open fractures in the EF group compared to IMN group.
In the IMN group the average surgery duration was 95.76 minutes and it was 69.4
minutes in the EF group. The average time for bone union was 25.66 weeks in
IMF group and 28.22 weeks in EF group. Complication rate was higher in EF group
with 11 complications (7 major & 4 minor) compared to IMN group with only 6
cases presenting with complications (3 each of major & minor).
CONCLUSIONS
Though IMN is the gold standard in treatment of femoral shaft fractures, EF in
polytrauma is an alternative method for definitive fracture stabilization, with
minimal additional operative trauma and an acceptable complication rate.
