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The outcome of antegrade intramedullary nail fixation of traumatic diaphyseal fractures of the femur in a tertiary care trauma center in Sri Lanka

Authors:

D. K. T. Kuruwitaarachchi ,

University of Colombo, Colombo, LK
About D. K. T.

Post Graduate Institute of Medicine

 

National Hospital of Sri Lanka, Colombo

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Y. Mathangasinghe,

University of Colombo, Colombo, LK
About Y.
Department of Anatomy, Faculty of Medicine
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D. Munidasa

National Hospital of Sri Lanka, Colombo, LK
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Abstract

Introduction

We evaluated the outcome, functional recovery, and complications of intramedullary nailing for fractures of the femoral shaft fractures.

 

Methods

A prospective observational study was conducted at the National Hospital of Sri Lanka. Patients with isolated femoral shaft fractures undergoing intramedullary nailing were followed up prospectively to assess the factors associated with better functional recovery (measured by Harris Hip Score (HHS) and Western Ontario and McMaster University osteoarthritis index (WOMAC)).

 

Results

Of 46 patients, the median age was 40(IQR=26-59) years. Majority had simple (n=34, 73.9%), closed (n=39,84.8%) fractures while seven (15.2%) had Gustilo Type I open fractures. Surgery was performed at a median of 9.5(IQR=6-14) days after the injury. Approximately two-thirds of the patients required reamed nailing (n=30, 65.2%). Three patients developed surgical site infections. X-rays obtained at four months demonstrated features of non-union in 13(28.3%). Leg length discrepancy (LLD) was present in 16(34.8%), and rotational deformity in one patient. Full and partial weight-bearing at six weeks was achieved in six and 23 patients respectively while 17 patients were unable to bear weight. The median HHS and WOMAC at four months were 66.5 and 36, respectively. Patients with proximal or distal diaphyseal fractures, female patients and those with full weight-bearing six weeks showed the best WOMAC index.

 

Conclusion

Proximal or distal diaphyseal fractures, female sex and ability to bear weight at six weeks post-surgery were associated with better functional outcomes at four months postoperatively. Surgeons should be mindful of the limitations of resource- poor settings which could affect the surgical outcomes.
How to Cite: Kuruwitaarachchi DKT, Mathangasinghe Y, Munidasa D. The outcome of antegrade intramedullary nail fixation of traumatic diaphyseal fractures of the femur in a tertiary care trauma center in Sri Lanka. Sri Lanka Journal of Surgery. 2022;40(2):1–5. DOI: http://doi.org/10.4038/sljs.v40i2.8953
Published on 31 Jul 2022.
Peer Reviewed

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