Muhammad Khalid, Imtiaz Hashmi, Sohail Rafi, Muhammad Idrees Shah.
Dynamization Versus Static Antegrade Intramedullary Interlocking Nail in Femoral Shaft Fractures.
J Surg Pak Jan ;20(3):76-81.

Objective: To compare the primary dynamic interlocking technique with static interlocking method for femoral shaft fractures in terms of bony union. Study design: Quasi experimental study. Place & Duration of study: Department of Orthopaedic Surgery, Ziauddin University Hospital Karachi, from March 2012 to August 2013. Methodology: All patients with closed femoral shaft fractures were treated by closed reamed intramedullary (IM) interlocking nail. They were divided into two equal groups. Group I (Dynamization group) patients underwent primary dynamization and in Group II (Static group) patients the static nail was used. Both groups were divided into subgroups on the bases of post reduction intrafragmental gap less than or more than 3mm on x-ray.The surgical procedure and postoperative protocols were same for both the groups, with the exception of interlocking mode. The outcome was measured using Thorensen clinical criteria. Bony union, time of union, delayed union, nonunion, implant breakage and leg shortening were recorded. Results: A total of 64 patients were included, 32 in each group. Mean time of union was same in dynamic group and static group with post reduction intrafragmental fracture gap < 3mm. In the dynamic group with post reduction intrafragmental fracture gap=3mm, one case of nonunion was noted. In static group two cases of delayed union and one case of nonunion were noted in sub group with post reduction intrafragmental fracture gap=3mm. Conclusion: Dynamization significantly shortened the mean time to union in femoral shaft fracture with intrafragmental gap =3mm, though it did not significantly affect the union rate of the femoral shaft fractures as compared to static close intramedullary interlocking nailing.

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