Journal of Musculoskeletal Trauma

Treatment of the Femur Shaft Fractures using Interlocking Nail: Jong Keon Oh, Soon Hyuck Lee, Seung Woo Suh, Young Soo Byun; J Korean Soc Fract 1997;10(2):289-294. Published online April 30, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.2.289

Abstract PDF: A series of forty patients who had forty femoral shaft fractures that were treated with static interlocking nailing were analyzed to determine the incidence of union of the fracture without planed conversion from static to dynamic intramedullary fixation as a technique to stimulate healing of the fracture. All of the forty cases were nailed using closed method under the guide of a image intensifier. The time to full weight was individualized for each patient and depend on the degree of comminution, the postoperative cortical contact between the major fragments, the presence of bridging callus as seen on follow up x-rays, and the patients mobility according to the associated injuries. Healing occurred in thirty nine(97%) of the forty fractures of the femoral shaft that had been treated with static interlocking nailing without dynamizaton. Only one patient needed conversion from static to dynamic interlocking fixation to promote fracture healing. This patient had a delayed union after closed interlocking nailing of Gustilo type I open midshaft fracture associated with Winquist type II comminution. We concluded that static interlocking nailing for femoral shaft fractures does not seem to inhibit the fracture healing process, and that conversion to dynamic intramedullary fixation is needed only for exceptional cases of delayed union.

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Treatment of femoral Shaft Fractures with Static Interlocking Intramedullary Nailing: Choong Hee Won, Seung Baik Kang, Kun Shin, Kyung Chul Jeon, Jin Sun Yoe, Kwan Hwan Jang; J Korean Soc Fract 1995;8(3):533-537. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.533

We managed thirty-five patients who had a fracture of the femoral shaft with interlocking fixation and twenty-five of thirty-five patients healed without conversion to dynamic intramedullary fixation and followed more than a year. The results of treatment of fractures of the femoral shaft with static interlocking nailing were reviewed. The average duration of follow-up was sixteen months(range, twelve to twenty-four months). Radiographic consolidation was seen in all fractures at a median of sixteen weeks(range, eight to twenty weeks). There were no non-unions. We concluded that routine conversion of static interlocking to dynamic interlocking is not necessary in the intramedullary nailing of the femur shaft fractures.

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Analysis of Risk Factors for Nonunion after Intramedullary Nailing of Femoral Shaft Fracture in Adult
Yong-Woon Shin, Yerl-Bo Sung, Jeong Yoon Choi, Minkyu Kim
Journal of the Korean Fracture Society.2011; 24(4): 313. CrossRef

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Interlocking Intramedullary Nailing with Transfixing Serew for Femur Shaft Fracture: Sung Kwan Hwang, Woo Yong Yi; J Korean Soc Fract 1992;5(2):289-299. Published online November 30, 1992; DOI: https://doi.org/10.12671/jksf.1992.5.2.289

Abstract PDF: Despite advances in fracture management. the long bone fracture have high rate of morbidity. Recently interlocking intramedullary nailing have gained increasing attention and accepta- nce as a treatment modality for femoral shaft fracture. Early proper fixation of long bone fractures is needed for early mobiliaation of the patient to facilitate pulmonary care and to prevent secondary complications due to prolonged bed rest and traction We treated twenty-eight patients of femur shaft fracture using interlocking intramedullary nails and transfixing screws. All twenty-eight fractures were nailed in static fashion initially. Twelve patients were randomly chosen and they were changed from statlc fixation to dynamic fixation at average 16 weeks after surgory. The purpose of this study was to compare the bone healing rates, clinical results, and postoperative complication between the static fixation group and dynamiaation group. The results were as follows ; 1. According to Winqulst-Hansen classification : 9 cases were type I : 7 cases, type II : 6 cases, type III : 4 cases, type IV and : 2 cases, type V. 2. All sixteen fractures, treated by static fixation achieved bony union(mean union time : 21 weeks). 3. Of twelve fractures with dynamization, eleven fractures were united (mean union time, 19 weeks). 4. Postoperative complications were limb shortening (4 cases : mean 0.7cm), nail breakage (1 case) and nonunion(1 case). We consider interlocking intramedullary nailing is the treatment of choice for closed or open femoral shaft fractures and dynamization is not an essential procedure for fracture healing.

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