Diaphyseal Femoral Fracture Fixation: Outcome of 108 Consecutive Fixations in a Tertiary Hospital

Abstract

Background: femoral shaft fractures are common orthopaedic problems and usually result from high energy impact with increased risk of associated injuries. Though global trend is moving towards early and effective fixation of fractures using options that cause minimal disruption of the soft tissue envelope around the fracture site, the practice in countries with weak health systems may vary from standard as predicted by available resources and skill. Aim: we present the outcome of surgical fixation of 108 femoral shaft fractures within a three year period. Method: Patients who meet inclusion criteria were recruited into the study after consent was obtained. Data was analyzed using SPSS 17 for windows and results were presented in frequency tables. Graphs and charts. Result: Femoral shaft fractures represents 3.8% of the total number of patients with orthopaedic conditions within study centre at the period of the study. The mean age was 31.2± 14.7 years with a M:F ratio of 2.1:1. There were more closed fractures (97; 89.2%) than open fractures (11, 10.8%) with transverse fractures being the most common fracture pattern (50.5%, n=46/108). Most fractures were treated by open reduction and locked intramedullary nailing (78/108, 72.5%) with bone union rates of 75% and 96% at 12weeks and 18 weeks post intervention respectively. There was no statistically significant difference in the union rate between the interlocking group and the plating group at both 12 weeks and 18 weeks post intervention (p=0.24). Bone infection, non-union and mal-union rates were 1.8% (n=2/108). Conclusion: femoral diaphyseal fractures can be effectively fixed with open locked IM nailing with optimal options are not available.