Assessment of Functional Recovery and Complications in Adult Diaphyseal Femur Fractures Treated With Closed Intramedullary Interlocking Nailing

TL;DR

This study shows that closed intramedullary interlocking nailing helps adults recover well from femur fractures with few complications.

Contribution

The study provides new evidence on the effectiveness of closed intramedullary interlocking nailing for diaphyseal femur fractures in adults.

Findings

Radiological union averaged 14.83 weeks and full weight-bearing occurred at 10.42 weeks.

Harris hip scores improved significantly from 71.45 to 85.27 over one year.

Complications occurred in 16.67% of patients, mostly superficial infections.

Abstract

Background: Adults often sustain high-energy injuries called diaphyseal fractures of the femur, which are typically treated surgically for the greatest cure.

Objective: This study evaluated the functional and radiological outcomes of adult diaphyseal femur fractures treated with closed intramedullary interlocking nailing over a 12-month follow-up using standardized clinical tools.

Methodology: This prospective observational study was conducted at the Department of Orthopedic Surgery, Bacha Khan Medical College, from January 2022 to December 2023. This study included 96 adult patients who had solitary diaphyseal femur fractures treated with closed intramedullary interlocking nailing. We gathered information on recovery parameters, fracture characteristics, and demographics. The Harris hip score and visual analog scale (VAS) were used to measure functional outcomes at six weeks, three months, six months, and one year. Data analysis was done using Statistical Package for the Social Sciences version 25.0 (IBM Corp., Armonk, NY).

Results: The average time to reach radiological union was 14.83 ± 3.12 weeks, and the time to full weight-bearing was 10.42 ± 2.65 weeks. The average range of motion was 122.3° ± 11.8° for the knee and 116.7° ± 10.5° for the hip. At one year, the mean Harris hip score increased from 71.45 ± 13.21 at six weeks to 85.27 ± 8.46, with 39.58% of patients having outstanding scores. The mean pain decreased from 5.27 ± 1.82 to 2.17 ± 1.35, indicating a substantial fall in VAS ratings as well. Sixteen patients (16.67%) had complications, with superficial infections accounting for most cases (n = 6; 6.25%). Transverse fractures (p = 0.035) and early weight-bearing (p = 0.038) were linked to better functional results.

Conclusion: Closed intramedullary interlocking nailing is an effective treatment for diaphyseal femur fractures, promoting early recovery with favorable functional outcomes and minimal complications.

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