STATIC VERSUS DYNAMIC INTERLOCKING INTRAMEDULLARY NAILING IN FRACTURES SHAFT OF FEMUR

Abstract

Background: Fractures of shaft of femur are a major cause of morbidity and mortality. The objective of this study was to compare outcome of static and dynamic interlocking nailing in closed femoral shaft fractures.
Material & Methods: This descriptive study was carried out at Department of Orthopaedics Surgery, Shaikh Zayed Hospital, Lahore, between September 2006 to September 2007. Fifty patients with transverse or short oblique closed fracture shaft of femur (Winquist and Hansen type I) were selected and divided into two groups of 25 each. In group A fractures were fixed in static mode i.e. applying both proximal and distal locking screw, while in group B fractures fixed in dynamic mode by applying only proximal or distal locking screw. Data was entered in computer software SPSS version 11 and was analyzed by using ‘t’ test.
Results: Out of 50 patients, 42 patients were male and 8 patients were female, with male to female ratio was 7:1 of static interlocking nail and 4:1 of dynamic interlocking nail. The minimum age of patient was 14 years and maximum was 70 years in both the groups with a mean age of 34.82 in group A and 32.55 in group B. The mean follow up of 6 months was carried out and our results showed that all fractures healed radiologically and clinically in 16.11 weeks in group A (static locking) while 19.37 weeks in group B (dynamic locking). One patient (4%) from group B developed shortening of 2 cm. Two patients (8%) developed delayed union from group A and were treated by dynamization. No patient from both the groups developed early postoperative complications like compartment syndrome, hemorrhage, pulmonary embolism or fat embolism.
Conclusion: Closed static interlocking intramedullary nailing is the effective way for management of transverse and short oblique femoral shaft fractures because of faster fracture union with lesser complications.