INTRAMEDULLARY NAILING OF FEMORAL AND TIBIAL SHAFT FRACTURE, A CROSS SECTIONAL STUDY, KSA

Background: A Cross-Sectional study done in King Abdulaziz National Guard Hospital in the department of Orthopedic. intramedullary nailing is a safer and famous surgical method. An original extension-apparatus has been developed, and the shape of the intramedullary nail and operative techniques has also been improved. Materials & Methods: A long-term experiment of the closed intramedullary nailing from July 2017 to August 2018 was done on 122 fractures, including 46 femur fractures for 85 patients and 76 tibia fractures for 98 patients. All patients were scheduled to have locked intramedullary nailing of fractures except those that were adjudged unsuitable. The locked intramedullary nailing systems used for the stabilization of the fractures were Russel Taylor, Pitkar, and Nebular systems. The alternate systems used were the conventional Kuntscher nailing and dynamic compression plate fixation. Antegrade closed intramedullary nailing, and in some cases with minimal opening at the fracture site to achieve reduction, were used. The medullary canals were reamed in all the cases and two screws were inserted to achieve proximal and distal locking in those stabilized with locked intramedullary nail. Parameters with regard to intraoperative blood loss, postoperative wound infection, length of hospital stay, and fracture union were followed up. Results: Currently of the fractures of the tibial shaft, x-ray tool continuity in fractured bone by callus, i.e. the cloudy shadow of callus filling the fragments, appeared in 33.6 days (average), and the bony closure, the mature spaced callus connecting the parts, was completed in 60.2 days (average). For fractures of the femoral shaft, the former appeared in 22 days and the latter was completed in 30 days. Keywords: Fracture, Femur, Tibia, Intramedullary nailing, various methods