All the data was retrieved from hospital records and supplemented by continuing follow up. They were divided into 2 groups on the basis of method of fixation used. Among those, 25 were treated by interlocking intramedullary nailing and 22 with MIPO. A total of 47 patients of closed comminuted femoral shaft fractures were studied. They included 39 males and 8 females - a ratio of 4.87:1. The mean age was 33.6 years (range 16 to 68). Most of the fractures were in age group of 21 to 40 years (96.6%). Most common sight was middle 1/3 (24 cases) followed by distal 1/3 (13 cases) and proximal 1/3 (10 cases). Most common cause was road side accidents (74.4%) followed by motorcycle and auto pedestrian accidents. In these 13 fractures were of type II, 17 of type III and 17 of type IV comminution. The average hospital stay was 12.8 days in nailing and 15 days in MIPO. The mean anaesthesia time for operative procedure in nailing was 116.6 minutes and in MIPO it was 83.4 minutes. At follow up, there were 2 cases of implant failure, one with broken interlocking screw and the other with loosened screw in MIPO. There was deep infection in 3 cases, 1 with nailing and 2 with MIPO. Knee stiffness was noted in 4 cases of MIPO and 2 cases in nailing but <100 degree in one case with MIPO. Delayed union was observed in 2 cases with nailing and 3 with MIPO group, in which we went for bone marrow injection and bone grafting in one case of nailing and MIPO each. Shortening of 2 cm in 1 case of nailing and 2 in MIPO was observed. Implant failure with loosened screws occurred after fall in one case of MIPO which required repeated fracture fixation. The mean fracture healing time in nailing was 16.88 weeks but in MIPO it was 19.82 weeks. According to Nicholas and McCoy score, there were 10 excellent, 9 good and 3 poor results and no failure. In nailing group 15 excellent, 8 good and 2 poor results but no failure. Closed interlocked I/M nailing is an excellent method of treating closed comminuted femoral shaft fractures, with advantages of lower complication rate and early weight bearing. MIPO is an acceptable method of treatment with advantages of being less expensive and short operative time.
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