External Callus Formation of Closed Femoral Shaft Fractures Treated by Medullary Fixation

Design: Study on the union pattern of femoral shaft fractures after interlocked intramedullary fixation. Objective: To assess the fracture healing pattern — the so-called callus types — and its formation speed, and age influence. Setting: Orthopedic and traumatic services. Material and methods: Among all the healed femoral shaft fractures, 10 patients at least in each decade from late teens to eighth decade who were regularly followed radiographically with a certain interval upto complete fracture union were chosen. Results: All the fractures healed primarily with external periosteal callus which was followed sometimes later by intercortical uniting callus with disappearance of fracture line. Conclusion: All the nailed femoral shaft fractures healed primarily by periosteal bridging callus irrespective of age, fracture type, and use of interlocking screws, though some less external callus formation after sixth decade was observed.

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Short-term outcome of patients with closed comminuted femoral shaft fracture treated with locking intramedullary sign nail at Muhimbili Orthopaedic Institute in Tanzania

Tanzania Journal of Health Research ◽

10.4314/thrb.v17i3.8 ◽

2015 ◽

Vol 17 (3) ◽

Author(s):

Billy T. Haonga ◽

Felix S. Mrita ◽

Edmundo E. Ndalama ◽

Jackline E. Makupa

Keyword(s):

Femoral Shaft Fracture ◽

Callus Formation ◽

Femoral Shaft ◽

Shaft Fracture ◽

Limb Length ◽

Short Term ◽

Term Outcome ◽

Femoral Shaft Fractures ◽

Shaft Fractures ◽

Image Intensifiers

Background: Comminuted femoral shaft fractures are complex to treat because of increased risk of limb length discrepancies and mal-rotation deformities. Currently the interlocking intramedullary nail using image intensifiers is a suggested treatment for comminuted femoral shaft fractures. This study aimed to evaluate the short-term outcome of patients with closed comminuted femoral shaft fracture treated with locking intramedullary SIGN nail without image intensifiers at Muhimbili Orthopaedic Institute (MOI) in Tanzania.Methods: A prospective hospital base study was conducted on patients with closed comminuted femoral shaft fractures admitted at MOI from March 2011 to February 2012. A total of 91 adult patients (18 to 84 years) were enrolled in the study. Of the total patients, 80 (88%) patients were male, 11 were lost to follow-up, and 80 patients completed follow-ups of 18 weeks post operatively. Structured questionnaires and checklist forms were used to collect information. Operations were carried out either by antegrade or retrograde SIGN nail. Post operatively control radiographs, the lower limb length and mal-rotation deformities were assessed.Results: Comminuted femoral shaft fracture accounted for 20.3% of all adult femoral shaft fractures admitted at MOI. Deep wound infection occurred in 2.5%. Shortening of 2-3cm was seen in 3.8% of the patients. No patient had shortening of more than 3cm. External rotation deformity of more than 20 degrees occurred in 6.3% of the cases. Internal rotation deformity of more than 15 degrees was seen in 7.9%. Knee flexion of less than 90 degree was encountered in 7.5% of patients. By 18th week 95% of the patients had callus formation. Conclusion: SIGN nail appears to be an effective treatment for comminuted femoral shaft fractures in settings where image intensifiers and fracture tables are not readily available. They have excellent to good outcomes in rate of callus formation, limb length and limb alignment outcomes.

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