DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20173995

Role of closed intramedullary interlocking nailing in comminuted fractures of long bones in lower limbs

Sanjeev Sreen, Manjit S. Daroch, Deepak Vashisht, Nitish Kapil

Abstract


Background: Fractures are the most common form of skeletal injuries encountered in orthopaedic practice. Increase in mechanization and high-speed travel are accompanied by increase in the number and severity of the fracture. Our ultimate goal of femur and tibia fracture management is restoration of alignment, rotation and length, preservation of blood supply to aid union, prevention of infection and early rehabilitation of the patient.

Methods: 30 adult patients of either sex with 30 comminuted fractures of long bones were treated with closed intramedullary interlocking nail. AO type B3 and C in femur and tibia are included. There were 25 males and 5 females, and average age of patients was 36.2 years. Out of 30 cases, 13 cases were of femur fracture while 17 cases were of tibia fracture. There were 21 closed and 9 patients had Grade I open fractures.

Results: Closed intramedullary interlocking nailing was done in 13 cases of femur fracture and 17 cases of tibia fracture. The average duration of partial weight bearing in femur fractures was 4.85 weeks and in tibia fractures was 5.53 weeks. 20 fractures united without additional intervention. The average duration of radiological union in femur fractures was 18.65 weeks and for tibia fractures was 19.29 weeks.

Conclusions: Closed intramedullary interlocking nailing is the treatment of choice of comminuted fractures of long bones in lower limbs which cause minimum damage to the blood supply of the fracture fragments which promotes the chances of bone union.


Keywords


Fracture, Intramedullary, Interlocking, Long bones

Full Text:

PDF

References


Klemm KW and Borner M. Interlocking nailing of complex fractures of the femur and tibia. Clin Orthop. 1986;212:89-100.

Wiss DA, Fleming CH, Matta JM. Comminuted and rotationally unstable fractures of the femur treated with an interlocking nail. Clin Orthop. 1986;212:35-47.

Canale ST, Beaty JH. Campbellā€™s Operative Orthopaedics; 2012;12(3):2560.

Klaus WK, Martin B. Interlocking nailing of complex fractures of femur and tibia. Clin Orthop Relat Res. 1986;212:89-100.

Chauhan N, Somashekarappa T, Singh A, Singh G, Rawal A. Interlocking nail in diaphyseal fracture of tibia: a clinical study; Int J Contemporary Med Res. 2016;3(6):50.43.

Giannoudis PV, Hinsche AF, Cohen A, Macdonald DA, Matthews SJ, Smith RM. Segmental tibial fractures: an assessment of procedures in 27 cases. Injury. 2003;34(10):756-62.

Nellaiyappan B, Vyravan PR, Mohankumar M, Doraikumar R. Complex femoral fractures: an analysis. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS). 2016;15(3):10-5.

Sahu RL. Fracture union with closed interlocking nail in segmental tibial shaft fracture; J Crit Rev. 2016;3(2):60-4.

Akhtar A, Shami A, Wani GR, Gul MS. Management of diaphyseal tibia fractures with interlocking sign nail after open reduction without using image intensifier. Ann Pak Inst Med Sci. 2013;9(1):17-21.

Kamruzzaman AHSM, Islam S. Result of closed interlocking intramedullary nail in tibial shaft fracture; Bang Med J (Khulna). 2011;44:15-7.

Borel JC, Dujardin F, Thomine JM, Biga N. Closed locked nailing of complex femoral fractures in adults. Apropos of 68 cases. Rev Chir Orthop Reparatrice Appar Mot. 1993;79(7):553-64.

Mohammad AK, Shah RK, Syed A, Gupta P. Interlocking intramedullary nailing in comminuted femoral shaft fractures. J Nobel Med College. 2012;1(2):50-6.

Melis GC, Sotgiu F, Lepori M, Guido P. Intramedullary nailing in segmental tibial fractures. J Bone Joint Surg Am. 1981;63(8):1310-8.

Kurupati RB, Raghavendra Babu YP, Shetty OBP. Management of fracture shaft of tibia with intramedullary interlocking nail: a clinical study. J Pharma Biomed Sci (JPBMS). 2012;22(22):1-4.

Al-algawy Alaa AH. Tibial shaft fractures treated with closed intramedullary nailing: a short-term outcome. Med J Babylon. 2010;7:4-3.

Anastopoulos G, Asimakopoulous A, Exarchou E, and Pantazopoulos. Closed interlocked nails in comminuted and segmental femoral shaft fractures. J Trauma. 1993;35(5):772-5.

Webb LX, Gristina AG, Fowler HL. Unstable femoral shaft fractures: a comparison of interlocking nailing versus traction and casting methods. J Orthop Trauma. 1988;2(1):10-2.

Siebenrock KA, Schillig B, Jakob RP. Treatment of complex tibial shaft fractures. Arguments for early secondary intramedullary nailing. Clin Orthop Relat Res. 1993;(290):269-74.

Youssef S, Mohamed El-Menawy, Mohamed Yahia. Evaluation of static locked intramedullary nailing for treatment of comminuted femoral shaft fractures. Egyptian Ortho J. 2014;49:101-7.