TREATMENT OF FEMORAL SHAFT FRACTURE AND PSEUDOARTHROSIS OF ADULTS BY INTERLOCKING INTRAMEDULLARY NAILING

Abstract

Introduction: Fractures of the femoral shaft are a major reason morbidity and mortality in patients with lower extremity injuries. Intramedullary nailing has many advantages over the other forms of internal and external fixation. From March 1995 to May 2001, 71 fractures of the femoral shaft of 69 patients were treated by interlocking intramedullary nailing. In this article, it was aimed to identify problems and to evaluated the outcomes of this method of treatment. Material and
Methods: Fivety-four patients have had unilateral acute fracture, two have had bilateral acute fracture and 13 have had pseudoarthrosis. Twenty-nine patients were women and 40 were men. The mean age of the patients was 40.8 years. The mean follow-up period was 41 months. The clinical and radiological evaluations of the patients were performed by using the criteria of Thoresen et al.
Results: The mean union time for acute fractures and pseudoarthroses were 21.8 and 22.4 weeks, respectively. According to the criteria of Thoresen et al., the results of 58 fractures of 56 patients with acute fractures were 45 (77.6%) perfect, 10 (17.2%) good and the results of 13 patients with pseudoarthroses were 8 (61.5%) perfect, 2 (15.4%) good.
Conclusion: The advantages of intramedullary nailing for fractures and pseudoarthroses of the femoral shaft are high rates of union and low rates of complication, good restoration of shaft alignment, early functional use of the extremity and a high comfort of the patients. It was concluded that interlocking intramedullary nailing should be considered as the first choice for the treatment of fractures and pseudoarthroses of the femoral shaft, when suitable indications and technical conditions are available.