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Treatment of communited & Segmental Femoral shaft Fracture by using Interlocking nailing: Comparison between Closed and Open techniques
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Chang Hyuk Choi, Koing Woo Kwun, Shin Kun Kim, Sang Wook Lee, Ho Sun Chang
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J Korean Soc Fract 1999;12(3):516-522. Published online July 31, 1999
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DOI: https://doi.org/10.12671/jksf.1999.12.3.516
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 Abstract
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- When femoral shaft fracture with severe communition and segmentation result from violent force, they are frequently associated with severe soft tissue damage.
Treatment of this unstable fracture need the rigid fixation in order to prevent shorting and rotational loading. In terms of this advantages, interlocking nailing technique was widely used with open and closed methods. In the cases of fractures that having large fragments and wide displacement, closed technique has disadvantage of difficulties in anatomic reduction and its maintenance.
Nineteen femoral shaft fractures had been treated by these techniques alternatively at our hospital between Feburary 1994 and Feburary 1997 and had been followed for more than 12 months. Among the 19 cases, closed techniques were 11 cases and open 8 cases. We evaluated the results of two treatment methods in terms of the bone union time, complications and functional results.
Mean duration of the bone union time was 24.2 weeks in closed interlocking nailing, 24.5 weeks in open. There was no difference between the bone union time and the operation techniques(p-value>0.05). And complications were delayed union in two cases.
In conclusion, in the cases of severe comminuted and segmental femoral shaft fractures especially with posteromedial fragment, open technique was more useful than closed technique, in terms of anatomic restoration and getting functional recovery afford to preinjury level of work.
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Closed Interlocking Nailing for Femoral Shaft Fracture -Comparison of results according to fracture comminution and site-
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Sang Wook Lee, Koing Woo Kwun, Shin Kun Kim, Chang Hyuk Choi, Ho Sun Chang
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J Korean Soc Fract 1998;11(3):528-532. Published online July 31, 1998
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DOI: https://doi.org/10.12671/jksf.1998.11.3.528
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Abstract
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- To compare of result according to fracture comminution and fracture site, we reviewed retrospectively 68 femoral shaft fractures treated by closed interlocking intramedullary nailing. The Winquist-Hansen classification was used to categorize the degree of comminution, and fracture site was categorized to three parts as proximal 1/3, middle 1/3, and distal 1/3. The results were analized and compared in each categorized group The average bone union time was delayed in more severely comminuted fracture and in distal 1/3 fracture compared to proximal 1/3 or middle 1/3. Varus angulation deformity was occurred more frequently in proximal 1/3 and severely comminuted fracture group, and posterior angulation deformity was occured more frequently in distal 1/3 fracture group. All but one case showed good functional results regardless of fracture comminution, fracture site and development of malalignment.
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Citations
Citations to this article as recorded by  - 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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