A clinical study on surgical management of diaphyseal fractures of tibia by intramedullary interlocking nail

SummaryThe purpose of this clinical study was to evaluate the technical feasibility of a method for pre-operative and intra-operative traction for reduction of fractures of the appendicular skeleton. Traction was used in 24 diaphyseal fractures in 21 dogs. For each dog, the data pertaining to signalment, limb circumference, fracture type, interval between fracture and surgery, and the traction modalities were recorded. In patients with a latency between trauma and surgery of less than three days, the duration of traction required to realign the bone segments was shorter than that required for older fractures (P = 0.02). Intraoperative malalignments were corrected by manoeuvres performed with the traction stand. Once realigned, fracture segments were kept stable for prolonged periods, without the need for a surgical assistant. Postoperative radiographs were evaluated for fracture reduction and axial alignment. Postoperative alignment was judged excellent in 21 fractures and good in three fractures. Fractures were stabilized using external skeletal fixation (n=10), plates (n=11) or locked nails (n=3), depending on the fracture type. The use of the technique was straightforward and easily applied in a surgical setting. However, its use requires careful application because of the potential for iatrogenic tissue damage.

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Study of management of diaphyseal fracture shaft femur by intramedullary interlocking nail

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20192109 ◽

2019 ◽

Vol 5 (4) ◽

pp. 588

Author(s):

Ayush Tiwari ◽

Sarabjeet Singh Kohli ◽

Manish Kokne

Keyword(s):

Primary Treatment ◽

Rotational Stability ◽

Diaphyseal Fracture ◽

Flexion Deformity ◽

Interlocking Nail ◽

Medical College ◽

Diaphyseal Fractures ◽

Free Function ◽

Femur Shaft

Background: Aim of this study was to analyze the effectiveness of interlocking nail in management of femoral diaphyseal fractures with special reference to fracture anatomy, pattern and status of stability.Methods: This hospital based prospective study was done in the department of Orthopedics, MGM Medical College Navi Mumbai. A total of 41 patients who were admitted in our institute was included to evaluate management of diaphyseal fracture shaft femur by intramedullary interlocking nail from July 2015 to July 2017. They were asked to follow up at 6 weeks, 3 months and 6 months.Results: Most of the fractures (70.7%) were united in 16-20 weeks while 10 (24.4%) fractures were united in 10-15 weeks and 2 (4.9%) fractures were united in 21-25 weeks. The mean time to union was 16.87±3.09 weeks. In the present study, 26 out of 41 patients had excellent results (63.4%) with full, pain free, function of the extremity. 13 patients with good result (31.8%), 9 patients had flexion deformity 1200, 3 patients had shortening 2 cm, 2 patients had shortening 1 cm. Two patients with fair result (4.8%), both had flexion deformity and none had with poor result. So overall, we had 95.2% excellent to good and 4.8% fair results.Conclusions: Interlocking intramedullary nailing is the most effective ad successful method of definitive primary treatment, in most types of fractures of femur shaft. It provides strong fixation, rotational stability and earliest return to functional status, as rate of healing is good with nailing.

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