Jagdesh Kumar, Ansar Shafique, Umar M.
Functional outcome of diaphyseal fracture of femur managed by locked intra-medullary nailing in adults.
J Pak Orthop Assoc Jan ;25(1):38-42.

Objective: The purpose of our study was to determine the outcome of diaphyseal fracture of femur managed by locked intramedullary nailing in adults and to compare these results with other available published studies. Study Design: Descriptive case series study. Place and Duration of study: Institute of orthopaedic and surgery Karachi from April 2010 to March 2012. Patients and Methods: A total of 54 femoral shaft fractures in 53 patients were analyzed. Average age of patient was 30.6. Out of these, 49 were males and 4 were females. 39 were closed fractures while 14 were open fracture Gustilo Anderson Type I. More than 50% were of complex pattern regarding fracture geometry. RTA was the most common mode of injury followed by firearm. Average operative time was 119 minutes. Average hospital stay was 8 days. 39 (72%) healed uneventfully, 6 (11.11%) showed delayed healing treated by dynamization but 3 needed bone grafting also. We also faced 3 (5.55%) mal-union, 2 (3.7%) cases of infection, 2 (3.7%) of implant failure and 2 (3.7%) had shortening of limb. Results: At the time of most recent follow-up (minimum of 6 months) according to modified Klaus &Klemm criteria. There were 61% rated as excellent, 22% as good, 11.11% as fair and 5.5% as poor. Conclusion: The results of aforementioned studies and our analysis suggest that intra-medullary interlocking nailing is an excellent technique to treat femoral shaft fractures in adults especially complex pattern regarding good healing, minimum complications, shorter hospital stay and early functional rehabilitation and most importantly early return to work and pre-fracture state.

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