STATIC VERSUS DYNAMIC INTERLOCKING INTRAMEDULLARY NAILING IN TRANSVERSE / OBLIQUE FEMORAL FRACTURES OF MIDDLE AND DISTAL THIRD

Abstract

OBJECTIVE: To compare the outcomes of static and dynamic interlocking intramedullary nailing in patients with transverse/oblique femoral fracture of the middle of the distal third. METHODOLOGY: This randomized controlled trial was conducted at Chandka Medical College to compared static and dynamic interlocking intramedullary nailing among the sample of 136 patients with transverse or oblique femoral shaft fractures. Patients were randomized after providing informed consent by using sealed opaque envelopes: Group A underwent reamed antegrade nailing with dynamic interlocking, and Group B underwent static interlocking fixation. Final outcomes assessed at 24 weeks which included non-union, delayed union, surgical site infection, and functional recovery using Thorensen’s criteria. Data were analyzed with SPSS, using p ≤ 0.05 for significance. RESULTS: In a study encompassing a sample of 136 participants (mean age 36.7 years; 72.8% male) diagnosed with mid-to-distal transverse or oblique femoral fractures, the utilization of dynamic interlocking nailing resulted in significantly lower rates of delayed union (5.9% as opposed to 27.9%, p=0.001), non-union (2.9% in contrast to 17.6%, p=0.004), and surgical site infection (4.4% relative to 20.6%, p=0.004), concurrently exhibiting enhanced functional outcomes (p=0.0001). CONCLUSION: It can be inferred that dynamic interlocking intramedullary nailing employed in mid-to-distal transverse and oblique femoral fractures exhibited markedly reduced incidences of delayed union, non-union, and surgical site infection, alongside enhanced functional outcomes when contrasted with static nailing. These results support that dynamic fixation is a better method for helping fractures heal and recover in the right patients.