Rotational malalignment after intramedullary nailing of femoral fractures.

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Abstract

[Indexed for MEDLINE] 14. Int J Surg Case Rep. 2023 Apr;105:108051. doi: 10.1016/j.ijscr.2023.108051. Epub 2023 Mar 24. Primary dynamic interlocking nail in femoral shaft fracture: A case series. Luthfi APWY(1), Hendarji A(2), Dalitan IM(3), Wedhanto S(3). Author information: (1)Department of Orthopaedic and Traumatology, Bhayangkara Tk.I R. Said Sukanto Police Hospital, Jakarta, Indonesia. Electronic address: wirapraja.med@gmail.com. (2)Bhayangkara Tk.I R. Said Sukanto Police Hospital, Jakarta, Indonesia. (3)Department of Orthopaedic and Traumatology, Bhayangkara Tk.I R. Said Sukanto Police Hospital, Jakarta, Indonesia. INTRODUCTION AND IMPORTANCE: Femoral shaft fracture is one of the most frequent injuries encountered by an orthopedic surgeon. Surgical treatment is commonly needed. Intramedullary nailing remains the gold-standard in surgical treatment of femoral shaft fracture. One of the constant dilemmas in intramedullary nailing is whether to use a static or dynamic locking screw for treating femoral shaft fractures. CASE PRESENTATION: We reported three cases of simple femoral shaft fracture and surgically fixed with primary dynamic interlocking nail. Closed reduction with reamed nail was performed in 2 cases, and mini open reduction with un-reamed nail was performed to the other one. Early weight bearing was instructed at day 1 post-operative. Mean follow-up period was 12.6 months. A solid bony union was achieved by all patients, and no complications were observed at the final follow up. CLINICAL DISCUSSION: Intramedullary nailing can be made static or dynamic. It is thought that in static mode of the intramedullary nailing, the axial weight is transferred through the locking screws rather than the fracture site, thus altering the callus formation and delaying fracture healing. A prompt dynamization of the fragments allows the contact of both fragments during mobilization and promotes early callus formation. CONCLUSION: Primary dynamic interlocking nail is an effective option for surgical treatment in simple or short oblique femoral shaft fracture. Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved. DOI: 10.1016/j.ijscr.2023.108051 PMCID: PMC10070616