Abstract

Introduction: The femur is the strongest bone in the body. Femoral shaft fractures are one of the common injuries encountered in orthopaedic practice. Fracture femur results from the drawbacks of fast life and violence more frequently as a result of road traffic accidents. They are major source of mortality and morbidity in patients with such injury.

Objectives: The purpose of this study was to assess the results of IMN surgery in adults in the fracture of the femoral shaft by open and closed methods.

Materials and Methods: This prospective study was carried out between November 2014 and November 2017 in Tertiary care institute. Antegrade nailing using the Standard intramedullary interlocking nail was performed on 30 cases who presented with shaft fractures of the femur. These cases of fracture shaft femur were treated by nailing. Data was collected from the patients attending the orthopedic department with fracture shaft of femur and satisfying the inclusion criteria.

Results: The common age group was ranging from 18 to 35 yrs. 24 patients were males, 6 were females. 23 patients had closed fracture, 3 had Gustillo Anderson Grade I compound and 4 had Grade II open fracture. In 10 patients fracture was at M/3rd, in 11 patients it was at L/3rd level and in 9 patients it was at U/3rd level. 4 patients were operated by open interlocking nail and other 26 by closed technique using C–arm. Injury surgery interval was 6.20 days on an average. Mean hospital stay was 12.16 days (5–34 days).  Range of knee flexion was full in over 90% of cases, 8% showed knee flexion from 0–120 degree and 2% showed 0–30 degrees of knee flexion. Mean time for union was more in patients treated by open procedure (20 weeks) as compared to closed technique (18.35 weeks) so full weight bearing was earlier and were in more patients in whom closed method was applied as compared to open method (p<0.005). We found 2 patients developed superficial infection, which healed completely none had deep infection.

Conclusions:  Interlocking intramedullary nailing is a very effective and successful method of definitive primary treatment, in most types of fractures of the shaft of the femur. Interlocking nail is effective in controlling rotational and longitudinal forces that act across the fracture site.