EVALUATION OF THE RESULTS OF INTRA MEDULLARLY INTERLOCKING NAIL IN THE MANAGEMENT OF FRACTURE OF DIFFERENT LONG BONES

Abstract

Intra-medullarly nail techniques for fracture fixation has gained Universal acceptance over the past 50 years. Closed interlocking nail fixation is the procedure of choice for femoral shaft fracture specially in poly trauma. Unlocked Nail can be considered when a non comminuted fracture occurs through the narrowest part of the medullarly canal. Unlocked Nail does not resist axial and rotational deformation of the fracture. Interlocking fixation controls bending and rotational deformation but allows nearly full axial load transfer by bone. Interlocking nails can be used in almost all long bones.

A total of 67 cases were stabilized by intra-medullarly interlocking nails. It was a prospective study done in SSMC & Private hospital from the period of January 2004 to February 2008. Total period of follow up was about 4 years. Both male & female were included in this series. Fresh, delayed fracture & Non Union all were included. Maximum cases were closed fracture but few were fresh but open fracture. Simple unstable fracture comminuted segmental fracture, implant failure was the selection criteria. Fracture, tibia femur and humerus were selected for this study. Both closed and open techniques were applied in this series without any support from C-arm.

In maximum cases bony union was achieved in expected time. In few cases healing process was delayed due to extensive soft tissue damage during the occurrence of fracture and non-cooperation of patients during post operative period. Excellent results were achieved in fresh cases. Over all result of this series is very satisfactory.

Breaking of screws was in 2 cases, bending of nail was in one case due to early weight bearing. Revision of surgery done in 2 cases.

Intra Modularly interlocking nail fixation is very simple device for unstable comminuted and segmental fracture shaft of long bones. If C-arm is available in that case procedure becomes more simple and easy. But without C-arm sometimes surgery becomes very lengthy and in that case expected results may not be achieved.