INTRODUCTION: Fractures of the shaft of femur are a major cause of morbidity and mortality in patients who sustain high energy trauma. Morbidity arises from limb shortening, mal alignment, knee
contractures and other complications of fracture. Mortality is infrequent but can result from an open wound, fat embolism, adult respiratory distress syndrome or multiple organ failure especially in the polytrauma patients. Both morbidity and mortality can be diminished by prompt reduction and internal fixation of the fracture (Robert A.,HansenT.et al. 1978 ). Restoration of alignment, rotation and length, preservation of the blood supply to aid union and rehabilitation of the patient is the goal of treatment. The type and location of the fracture, degree of comminution, the age of the patient, patients social, economic demands and other associated fractures may influence the method of treatment. Currently intramedullary, interlocking nailing is considered to be the treatment of choice for complex femoral shaft fractures.
AIM: The aim of our study is to analysis the results of complex femoral shaft fractures treated by intramedullary interlocking nailing in our institution.
MATERIALS AND METHODS: Between the oct 2006-nov2008., 20 cases of complex femoral fractures were treated with intramedullary interlocking in Govt General Hospital were included in our study.19 patients were male and one was female. Age group of these patients were ranging from 18-78 years. Inclusion Criteria - complex femoral fractures in adults. Exclusion Criteria - All Compound fractures. All Fractures in the paediatric and adolescent age group. Associated head injury, visceral injuries. Old fractures. All the complex femoral shaft fractures were examined throughly to look for associated injuries, neurovascular damage. Thorough examination of the ipsilateral hip and knee was performed. All the fractures were stabilized initially with thomas spilnt, plaster immobilization and pin traction. All patients were stabilized hemodyanamically with intravenous fluids, blood transfusion as required.
RESULTS: In 10 patients with excellent results there was no shortening, mal alignment, no pain or swelling in the fracture site and movements of hip, knee were near normal. In 5 patients with good results had shortening of 1 cm and knee flexion of 120o. In 3 cases with fair results had limb shortening; and knee flexion of between 900-1200. In 2 cases of with poor results had limb shortening of 2 cm and knee stiffness. The range of movements of knee less than 90o. All the patients had fractures of both bone leg and that could be the cause of knee stiffness.
CONCLUSION: Our study consists mostly of male patients in their active part of their life. So, there is a need for quick return of their daily routines. Intramedullary interlocking nailing for complex femoral fractures has been established world wide as the gold standard treatment because of its load sharing property, internal splinting, and rotational stability. These contribute the stable osteosynthesis. When the patients are taken up for surgery earlier, fracture reduction can be achieved by closed method and yield early fracture union, excellent functional outcome and prevention of complications. Early mobility, a low rate of complications and high
incidence of union obtained in this study in majority of patients makes this technique more reliable
