Interlocking nail for femoral shaft fractures: is dynamization always necessary?

Objective: The aim of this study is to compare the effectiveness of retrograde femoral interlocking nail versus dynamic condylar screw in distal femoral shaft fractures. Study Design: Prospective/Randomized comprehensive Place and Duration: Department of Orthopaedic Surgery Bahawal Victoria Hospital (BVH) / QAMC, Bahawalpur for duration of eight months i.e July 2020 to February 2021. Methods: Total 65 patients of both genders were presented in this study with age ranges between 20-40 years. Patients detailed demographics age, sex and BMI were calculated after taking informed written consent. Patients were divided into 2- groups, I and II Group I had 32 patients and underwent for retrograde femoral interlocking nail and group II had 33 patients and received dynamic condylar screw. Mean operative time, mean union time of bones and complications were calculated. Effectiveness among both groups was calculated by HSS score. Complete data was analyzed by SPSS 22.0 version. Results: Most of the patients were males 40 (61.54%) and 25 (38.46%) were females. Mean age of the patients in group I was 26.46±4.28 years and in group II mean age was 30.78±8.22 years. Mean operative time in group I was 82.8±7.14 minutes while in group II it was 90.6±8.19 minutes. Mean union time in group I was 22.7±2.5 weeks and in group II was 26.21±5.3 weeks. According to HSS score in group I 16 (50%) results were excellent, 11 (34.38%) was good, 3 (9.8%) showed moderate and 2 (6.25%) was poor, while in group II excellent results were 15 (45.45%), 10 (30.30%) was good, 5 (15.15%) showed moderate and 3 (9.09%) showed poor results. Complications were observed joint stiffness, delayed union, non union and varus deformity were significantly lower in group I as compared to group II. Conclusion: We concluded in this comparison of study that bothretrograde femoral interlocking nail and dynamic condylar screw was useful and effective methods for trauma in distal femoral shaft fractures. But less union time and good outcomes were observed in interlocking nail as compared to dynamic condylar screw. Keywords: Distal femoral shaft fractures, Trauma, Dynamic condylar, Interlocking nail

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Fatigue Fracture of the Interlocking Nail in the Treatment of Femoral Shaft Fractures

Journal of the Korean Fracture Society ◽

10.12671/jksf.2003.16.2.163 ◽

2003 ◽

Vol 16 (2) ◽

pp. 163

Author(s):

Jung Ryul Kim ◽

Jin Ho Yoon

Keyword(s):

Fatigue Fracture ◽

Femoral Shaft ◽

Femoral Shaft Fractures ◽

Interlocking Nail ◽

Shaft Fractures

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Insertion of the distal screws in interlocking nail fixation of femoral shaft fractures. Technical note.

The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-198668080-00019 ◽

1986 ◽

Vol 68 (8) ◽

pp. 1275-1277 ◽

Cited By ~ 19

Author(s):

R J Medoff

Keyword(s):

Femoral Shaft ◽

Technical Note ◽

Femoral Shaft Fractures ◽

Interlocking Nail ◽

Shaft Fractures

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Failures of the Nail in the Treatment of the Comminted Femoral Shaft Fractures with Interlocking Nail: Analysis of 6 cases

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.1996.31.5.1159 ◽

1996 ◽

Vol 31 (5) ◽

pp. 1159

Author(s):

Sang Don Jeong ◽

Won Tae Choi ◽

Seong Kwon Rho ◽

Je Gyun Chon

Keyword(s):

Femoral Shaft ◽

Femoral Shaft Fractures ◽

Interlocking Nail ◽

Shaft Fractures ◽

Nail Analysis

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Complications following comminuted femoral shaft fractures treated with interlocking nail with or without inter fragmentary screw fixation for butterfly fragment: case series

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20174708 ◽

2017 ◽

Vol 3 (6) ◽

pp. 1170

Author(s):

Muthukumar Kaliamurthy ◽

Rajarajan Elumalai ◽

Vijay Krishnan Arcot Subramaniyan

Keyword(s):

Bone Grafting ◽

Screw Fixation ◽

Healing Process ◽

Case Series ◽

Femoral Shaft ◽

Infected Nonunion ◽

Femoral Shaft Fractures ◽

Interlocking Nail ◽

Shaft Fractures ◽

Primary Bone

Background: This case series is to highlight the complications following interfragmentary compression screw fixation for butterfly fragment while treating femoral shaft fractures with interlocking nail.Methods: Twelve cases have been included in this study conducted in institute of orthopaedics and traumatology, MMC & RGGGH, Chennai. All patients had shaft of femur fracture with butterfly fragment for which open reduction and interlocking nailing done. For 6 patients we applied interfragmentary screws for the butterfly fragment and in rest of the patients (6) patients we left the butterfly fragment in situ without disturbing the soft tissue attachment and bone grafting for the bone gap where ever necessary. We followed up the patient at 3 weeks, 6 weeks and 12 weeks, 6 months and 12 months.Results: All the six patients fixed with inter fragmentary screws had wound infection and went for infected nonunion for which appropriate management was done including revision nailing or LRS application. Union was achieved in 12 to 16 months after various surgical interventions. Remaining six patients in whom interfragmentary screws were not applied and primary bone grafting when and where necessary was done, showed radiological union by three months.Conclusions: Blood supply to large butterfly fragment is the main key for the healing process not the near normal anatomical reduction using interfragmentary screw for the butterfly fragment. Relative stability is enough for fracture union. In bone defects arising out of comminution primary bone grafting is essential for the bone healing.

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