Syed Baqir Hussain Jafree, Adeel Hamid, Rashid Saeed.
Results of Early Interlocking Intramedullary Nailing in Fractures of Femoral Shaft.
Pak J Med Health Sci Jan ;6(3):733-6.

Objective To determine the results of early intramedullary fixation in closed and grade 1 open fractures of the femoral shaft in terms of patient compliance rehabilitation and complications Design descriptive cross sectional study. Place of study Department of Orthopaedic Surgery Jinnah Hospital Lahore from January 2010 to January 2011. Materials and methods: 40 patients having closed and grade 1 open fractures of the femoral shaft who presented in the accident and emergency department were included in the study. In all patients the fractures were managed by static interlocking intramedullary nailing after reaming of the medullary cavity. The average stay of the patient in the hospital was 4 days. At each follow up, the patient were assessed for the parameters like knee range of movements, fracture healing, return to independent ambulation, complications and need for any additional procedure. The data regarding these parameters for each of the patient was analysed statistically to ascertain the success of the procedure. Results: The ages of the patients ranged from 15-50 years. The modes of injury were road traffic accidents, fall from height or direct trauma. 25 had closed fractures and 15 had grade 1 open fractures. Time to radiological union was 18-24 weeks with an average if 22 weeks. Time from bed to chair movement to toe touch ambulation to full weight bearing was 10-18 weeks with an average of 14 weeks. Patients who complied strictly with the rehabilitation had knee range of movement 0-120 degrees on average only 5 patients had knee range of movement from 0-90 degrees .Only 2 patients developed superficial infection which was successfully treated by antibiotics. Conclusion: Closed intramedullary nailing is a far better option for the treatment of fractures of the femoral shaft. Not only is it associated with less morbidity but due to less surgical dissection and considerably better and rigid fixation , the patiens satisfaction is also good, there is less incidence of infection, shorter duration of hospital bed occupancy and far better outcomes of the rehabilitation efforts.

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