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ORIGINAL ARTICLE
Year : 2016  |  Volume : 6  |  Issue : 2  |  Page : 96-99

Locked intramedullary nailing for tibial and femoral shaft fractures: Challenges and prospects in a Tertiary Health Care Facility in a resource constraint setting


Department of Orthopedics and Trauma Surgery, Ahmadu Bello University, Zaria, Nigeria

Correspondence Address:
Ismail L Dahiru
Department of Orthopedics and Trauma Surgery, Ahmadu Bello University, Zaria
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-9596.194982

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Background: Locked intramedullary nailing for operative fixation of tibial and femoral shaft fractures has become the gold standard in the operative stabilization of these fractures. The results of these procedures from various centers have been quiet impressive and compares to that reported globally. The sustenance of these important procedures are however not without challenges, which is the main reason for reporting the experience from our institution. Patients and Methods: This is a prospective study involving 163 consecutive patients with closed tibial and femoral shaft fractures over a period of two years (June 2011 to May 2013). Parameters such as blood loss, postoperative wound infection, length of hospital stay, and fracture union were followed up. Results: One hundred and fifteen (70.6%) of the patients were males while 48 (29.4%) were females. Of the 176 operations, 136 (77.3%) were carried out for femoral shaft fractures whereas 40 (22.7%) were carried out for tibial shaft fractures. Thirty eight (21.6%) femurs and 14 (7.9%) tibiae had locked intramedullary nailing. Intraoperative blood loss was less than 250 ml in patients who had locked intramedullary nailing, and the average length of hospital stay was 10 and 16 days for those that had locked intramedullary nailing and plating, respectively. Forty-four (84.2%) fractures stabilized with locked intramedullary nail showing solid union at 16 weeks whereas only 32 (70%) and 55 (70%) of the fractures stabilized with Kuntscher nail and plate, respectively, showing solid union at 16 weeks. Conclusion: Our study suggests satisfactory outcome with locked intramedullary nailing for the operative fixation of tibial and femoral shaft fractures. The choice of implant to be used depends significantly on affordability by patients and to a lesser extent on surgeon's preference.


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