Study of results of intramedullary nailing in segmental fracture femur

Abstract

Orthopaedic surgeons often encounter segmental 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. While the main stay of the treatment has been reamed intramedullary nailing. Methods: We studied a total of 50 patients of segmental fracture femur admitted in the orthopaedic department, treated with intramedullary nailing. The common age group was ranging from 20 to 41 yrs with average age group of 35.85 yrs. 22 patients were males, 8 were females. 23 patients had closed fracture, 7 had open fractures. 12 patients were operated by open nail and other 18 by closed technique using C-arm. Results: 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 patient developed superficial infection, which healed completely and 2 had deep infection with nonunion. In our series of 30 patients, 21 patients had excellent results, 9 patients had good results and 1 had fair result. Conclusions: Intramedullary nailing is a very effective and successful method of definitive primary treatment, in most types of segmental fractures of the femur. It is effective in controlling rotational and longitudinal forces that act across the fracture site. 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 reduce rehabilitation.