English

Abstract

BACKGROUND Femoral shaft fractures result from high energy trauma and maybe associated with life threatening conditions. Typical in younger people is associated with polytrauma. Though intramedullary nailing (IMN) is the gold standard option of treatment, external fixation (EF) can also be used temporarily or definitively, in such cases. The aim of this study was to compare the functional outcome of these two procedures. METHODS This prospective comparative study was conducted at our centre over a period of 6 years. Age, sex of the patients, laterality, type of fracture with mean follow up, union time, and complications such as delayed union, angular deformities, and limb length discrepancies were tabulated and compared. RESULTS There were more cases of open fractures in the EF group compared to IMN group. In the IMN group the average surgery duration was 95.76 minutes and it was 69.4 minutes in the EF group. The average time for bone union was 25.66 weeks in IMF group and 28.22 weeks in EF group. Complication rate was higher in EF group with 11 complications (7 major & 4 minor) compared to IMN group with only 6 cases presenting with complications (3 each of major & minor). CONCLUSIONS Though IMN is the gold standard in treatment of femoral shaft fractures, EF in polytrauma is an alternative method for definitive fracture stabilization, with minimal additional operative trauma and an acceptable complication rate. KEYWORDS Femoral Shaft Fractures, Intramedullary Nailing, External Fixation, Polytrauma, Definitive Treatment