The results of locked intramedular nailing osteosinthesis in long tubular bone fractures

Abstract

The aim of this study: were the analysis of the results in healing of diaphyseal long tubular fractures by osteosinthesys with intramedulary locked nails in patients treated in IEM. Materials and methods: during the period of 2010-2015 years in the department of Orthopaedia of IEM there were examined and treated 314 patients with diaphyseal long tubular fractures (329 fractures on different levels) treated by intramedular ostesinthesys using locked intramedular nails. The group was consist of 203 (64,665%) male and 111 (35,35%) female patients. Average age was 40,4 years old (18-89 years old). The distribution by fractured segments is: humerus – 37 (11,3%), femur – 159 (48,3%), tibia – 133 (40,4%) patients. In 20 (12,6%) cases the femur was treated by retrograde osteosinthesis and in 130 (81,8%) – anterograde and in 9 (5,6%) cases – by combinant method Betisor-Darciuc. In 131 (98,5%) cases the tibial shaft fractures were fixated by anterograde and in 2 (1,5%) cases – combinant methods. All the humeral shaft fractures included in the study were fixated anterograde. Results: according to functional scores LEFS and DASH the results are distributed as excellent in 294 cases (89,36%), good in 33 cases (10,03%), unsatisfactory in 2 cases (0,61%). As the complications there were inregistrated: instability of proximal femoral screw – 3 cases, damage of femoral nail -1case, damage of tibial nail – 1 case, instability of humeral fixator – 1 case. Conclusions: intramedular nailing osteosinthesis represents a favorable method for healing the long tubular bone fractures. This method represents reduced surgical traumatism, less hemorrhage, early mobilization and low risk of perioperative complications.