Treatment of acute fractures of the femoral shaft with reamed intramedullary interlocking AO nails. | [Journal of Pakistan Medical Association • 2004]

Author(s):

1. M. Umer: Departments of Orthopedic Surgery, General Surgery and Research, Aga Khan University Hospital, Karachi, Pakistan

2. A. K. Niazi: Departments of Orthopedic Surgery, General Surgery and Research, Aga Khan University Hospital, Karachi, Pakistan

3. D. Hussain: Departments of Orthopedic Surgery, General Surgery and Research, Aga Khan University Hospital, Karachi, Pakistan

4. M. Ahmad: Departments of Orthopedic Surgery, General Surgery and Research, Aga Khan University Hospital, Karachi, Pakistan

Abstract:

To review and audit our experience with closed intramedullary interlocking nailing for acute femoral shaft fractures. All patients admitted to The Aga Khan University Hospital, over the last six years and with a minimum follow-up of twelve months, with acute fractures of the femoral shaft were included in the study. All patients treated for established non-unions and infections or with pathological fractures were excluded from the study. There were 89 fractures, 74% of whom were closed and 50% were associated with other orthopedic injuries. Most of these were younger patients involved in high velocity road traffic accidents.The union rate was 88% with 4.4% of fractures going into non-union. The remaining 8% of the fractures went into a phase of delayed union, but ultimately united, making the overall success rate to be 95.6%. The mean time for union was 11.5 weeks. At the final clinical follow-up, 4% of the patients had minor pain, 7% had limp, 4% had leg length discrepancy of more than 2cm and 4% had decreased range of motion at the hip or knee joints. We had a 4% rate of superficial infection. There were 3 cases of pudendal nerve neuropraxia and 2 cases of deep vein thrombosis. Intramedullary Interlocking nailing is a safe and effective treatment modality for acute fractures of the femoral shaft. Proper surgical decision making regarding static versus dynamic mode of locking can avoid problems of delayed union.

Page(s): 423-427

DOI: DOI not available

Published: Journal: Journal of Pakistan Medical Association, Volume: 54, Issue: 8, Year: 2004

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