Zulfiqar A Qureshi, Syed Wasif A Shah, Jugdesh Kumar, Yousaf M.
Management of diaphyseal femur fractures in adults with intramedullary interlocking nail.
Biomedica Jan ;28(2):117-20.

Background: Fracture of femur in adult patients presents special problems. Orthopaedic surgeons often encounter diaphyseal femur fractures, because these fractures most often result from high – energy trauma, one must have high index of suspicion for complications. Currently reamed interlocking nailing is indicated for most femur fractures because of high rate of union, low rate of complications and advantage of early stabilisation which decreases the morbidity and mortality rate in patients. The objective was to determine the functional outcome of intra-medullary interlocking nailing in diaphyseal fracture of femur in adults in terms of early rehabilitation and fracture healing. Patients and Methods: This prospective study was carried out from 1.9.2008 to 31.3.2010 in the Department of Orthopaedics, Social Security Teaching Hospital, Lahore. Twenty five patients aged between 20 – 50 years having fracture diaphysis of femur were included. Patients less than 18 years of age, open grade III fractures and pathological fractures were excluded from the study. Routine preoperative investigations were done. Radiological assessment included AP and lateral radiograph of thigh with hip and knee and chest PA/AP view. Results: There were 21 males and 4 females with male to female ratio 5.25:1. The age ranges from 20 – 50 years with mean age of 31.2 years. Majority of the fractures were spiral fractures seen in 9 cases. Comminuted fracture seen in 8 cases, oblique fracture seen in 5 cases and transverse fractures were seen in 3 cases. The results obtained were excellent in 13 patients, good in 9 patients, fair in 2 patients and poor in 1 patient. Mean time of fracture healing was observed 14.3 ± 1.3 with range of 12 – 16 weeks. Conclusion: The most preferred treatment in the management of fracture diaphysis of femur is intra-medullary interlocking nail especially in skeletally mature patients as regards early rehabilitation and fracture healing.

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