Functional Outcome of Closed Locked Intramedullary Nailing of The Femoral Shaft Fracture

Abstract

Background: Femoral shaft fractures are common adult injuries, necessitating effective treatment strategies to optimize patient outcomes. Closed locked intramedullary nailing is widely recommended for femoral shaft fractures due to its high union rates. Objective: This study aims to determine the outcome of managing closed femoral shaft fractures in adult patients using Closed Femur Nailing. Methods: This prospective study was conducted at the Department of Orthopedics, Rangpur Medical College Hospital, and a multicentral private hospital in Rangpur Zone from January 2016 to December 2019. Adult patients aged 16 years and above, presenting with closed femoral shaft fractures within two weeks of injury, were included, while pathological fractures were excluded from the study. Standard techniques were employed for the Closed Femur Nailing procedure, and each patient was followed up for at least 1 year. Results: A total of 112 adult patients were enrolled, with a mean age of 36.9 ± 11.7 years and a male-to-female ratio of 2.9:1. Road traffic crashes were the predominant cause of closed femoral shaft fractures (95.3%), with motorcycle-related incidents being the most prevalent (56.1%). The study demonstrated an impressive union rate of 95.3%, with an average time to radiological union of 14.0 ± 1.2 weeks and a mean time to painless full weight-bearing of 14.2 ± 1.2 weeks. Complications encountered included broken nails (4.7%), infection, loosening of the distal screw, and limb length discrepancy (2.3% each). Thoresen's criteria revealed excellent results in 93% of patients, with poor outcomes in only 4.7%. Conclusion: Closed Femur Nailing emerges as an effective and reliable method for managing closed femoral shaft fractures in adult patients, yielding excellent clinical outcomes with a high union rate and relatively low complication rates.