Results of Antegrade Closed Static Femoral Interlocking Nailing for Closed Femoral Shaft Fractures………………………………………………….…………………….……

Abstract

objective: To evaluate the results of closed antegrade static femoral nailing for closed Winquist type III and IV fractures of shaft femur.Methodology: A descriptive study conducted at department of Orthopedic surgery in Al Kadhimya hospital from March 2008 to July 2010. Twenty eight patients are included, twenty male patients and eight females , three were missed during follow –up period, admitted to the emergency department and operated on with closed reamed interlocking ante grade nailing under general or spinal anesthesia within 72 hours. Followed up for one year looking for union rate, malunion, infection, knee joint stiffness and trendelinburg gait.Results: Union was achieved within twenty weeks in (twenty two 88%) patients, delayed union until thirty six weeks in (two 8%) patients and (one 4%) patient developed non union proved clinically and radiologically.Infection developed in two patients (8%) at the site of distal screw insertion, both were superficial and resolved conservatively.Knee joint stiffness developed in six patients (24%), from which five resolved completely within six weeks of physiotherapy and one with long term less than twenty degree knee joint stiffness.Trendelenburg gait developed in four (16%) patients, three (12%) resolved completely within ten weeks and one patient (4%) continues with Trendelenburg gait after one year.The mean operative time was 90 minutes.Malunion as shortening less than one cm developed in two cases (8%) and angulations less than 10 degrees in one case (4%).Key words: Closed, reamed, ante grade, static interlocking nails, femoral shaft fracture.