Clinical outcome of closed intramedullary interlocking nailing in comminuted fractures of the femur.

Abstract

Objective: To determine the clinical outcome of closed intramedullary interlocking nailing in comminuted fractures of the femur. Study Design: Retrospective Study. Setting: Department of Orthopaedics & Spine Centre, Ghurki Trust Teaching Hospital, Lahore. Period: January 2022 to December 2022. Methods: The study included 50 patients who fulfilled the inclusion criteria. Patients with Gustillo Anderson Class I fractures, patients with pathological fractures, and patients aged 18 to 65 years of both sexes were included in this research. Patients with serious injuries were not included. The data was gathered via non-probability, sequential sampling. The patients had spinal anaesthesia for their operations after providing written informed permission. Three months after surgery, patients were evaluated again to determine the functional result using modified Klaus & Klemm criteria. SPSS version 25.0 was utilized for doing statistical analysis. Using stratifications, effect variables such as age, gender, and injury manner were controlled. A chi-square test after stratification was used to examine their impact on the result; A p-value is considered significant if it is less than 0.05. Results: The results indicate that the majority 90% were male patients and only 105 cases were females with the mean age of patients 33.34±13.87 ranging from 18 to 60 years. Road Traffic Accidents (RTA), comprising 64.0% of the total sample. Falls were the mode of injury for 8 cases, accounting for 16.0%. Other modes of injury were reported in 10 participants, representing 20.0%. According to clinical outcome, 33(44%) cases found with excellent functional outcome, 18(36%) with good, 8(16%) with fair and 1(2%) with poor outcome. Only the mode of injury was significantly associated with the clinical outcome as p<.05. Conclusion: The best treatment for comminuted long bone fractures in lower limbs is closed intramedullary interlocking nailing, which increases the chance of bone union and reduces disruption to the fracture pieces' blood supply. Other advantages of interlocking nails include a reduced length of hospital stay, early weight bearing, early muscle rehabilitation, early joint mobilization, and—above all—an early return to employment and pre-fracture status.