Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Trauma - Femur
Abstract number: 25278
EXPANDABLE SELF-LOCKING NAIL IN THE MANAGEMENT OF CLOSED
DIAPHYSEAL FRACTURES OF FEMUR AND TIBIA -OUR EXPERIENCE
AASHISH CHAUDHRY 1 , SUDHIR K KAPOOR 2 , SAURABH KAPOOR 3
1 SUSHRUTA TRAUMA CENTRE, NEW DELHI (INDIA), 2 PGIMER, ESI HOSPITAL,
NEW DELHI (INDIA), 3 GOVERNMENT MEDICAL COLLEGE, CHANDIGARH
(INDIA)
Introduction: Intramedullary fixation is the treatment of choice for closed diaphyseal
fractures of Femur and Tibia. Conventional interlocking nails depend primarily on
locking screws for axial and rotational stability. We used an expandable
intramedullary nail which does not rely on interlocking screws, and achieves axial &
rotational stability on hydraulic expansion of the nail. The flexibility of instrumentation
and the avoidance of interlocking screws make them less time consuming, with
minimal exposure to radiation. Methods: We prospectively studied 32 patients of
closed diaphyseal fractures of tibia and femur treated with this self locking,
expandable nail. Closed or open reduction and internal fixation with expandable nail
stabilises these fractures with minimum radiation exposure & operative time, as no
locking screws were used. Early mobilisation and weight bearing was started
depending on fracture personality and evidences of healing. Patients were followed
till clinical and radiological union. Results: The average operative time was 90
minutes for femoral fractures and 53 mins for tibial fractures. Radiation exposure was
minimum, average being 84 seconds for femoral fractures and 54 seconds for tibial
fractures. All fractures healed with few complications. Mean time of union was 5.1
months for femoral fractures and 4.8 months for tibial fractures. Complications
included infection(1), bent femoral nail(1), rotational instability(1) and delayed
union(3).Conclusion: The surgical time required is less with minimum complications.
The main advantage of the expandable nail is satisfactory axial, rotatory and bending
stability with decreased radiation exposure to operating staff and the patient.
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