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Title: Comparison of Solid versus Cannulated Interlocking Nail in Fracture of Shaft of Femur in Adults
Authors: Muhammad Javaid Iqbal, Ajmal Yaseen, Sajjid Rasool, Rasul Ahmad Chaudhry
Journal: Annals of Punjab Medical College
Publisher: Punjab Medical College
Country: Pakistan
Year: 2010
Volume: 4
Issue: 2
Language: English
Keywords: Interlocking NailFracture shaft femur
Objectives: The aim of this study was to compare the outcome of solid versus cannulated interlocking nails as a method of internal fixation in closed femoral shaft fractures in adults.  Study Design: Quasi Experimental.  Place and Duration of Study: Orthopaedic Department Allied Hospital, Faisalabad a teaching hospital affiliated with Punjab medical college, Faisalabad. Duration of study was from Jan 2007 to Dec 2008.  Patient & Methods: The study was based on sixty cases. Thirty cases were included in either group of solid and cannulated intramedullary interlocking nails. The solid interlocking nailing group was designated as group A, the cannulated as group B. The most common cases were road traffic accidents. The average hospital stay was 6 days. The follow up time was 9 months. Results: : In group A we have union time within 3 months in 26(86.66%) patients, delayed union in 3(10%) patients & non union in one patient(3.33°%).Three patients in group B(10%) went into non union, one due to deep infection, onedue to implant failure & breakage of nail & one with no apparent cause. Regarding infection we had superficial infection in one patient of group A & two patients of group B which was corrected with appropriate antibiotics. No case of deep infection occurred in group A but one in group B which went into non union. Regarding implant failure, we had no implant failure in group A & four cases of implant failure in group B with one nail breakage, two  distal locking screw breakage &one proximal locking screw breakage.   Conclusion: The most common cause of femoral shaft fractures is road traffic accident with male adult population affected the most. There was no statistical difference in union & infection in both groups. (p value >0.05).There was significant difference in implant failure in both groups with no patient in group A & four in group B (p value <0.05). So solid interlocking nail is stronger than cannulated one.
To compare the outcome of solid versus cannulated interlocking nails as a method of internal fixation in closed femoral shaft fractures in adults.
Quasi-experimental study involving 60 adult patients with closed femoral shaft fractures. Patients were randomly assigned to two groups: Group A (30 patients) received solid interlocking nails, and Group B (30 patients) received cannulated interlocking nails. Outcomes were assessed based on union time, infection rates, and implant failure.
graph TD;
A["Patient Recruitment n=60"] --> B["Random Assignment"];
B --> C["Group A: Solid Nail n=30"];
B --> D["Group B: Cannulated Nail n=30"];
C --> E["Surgical Fixation"];
D --> E;
E --> F["Follow-up 9 months"];
F --> G["Data Collection Union, Infection, Implant Failure"];
G --> H["Statistical Analysis"];
H --> I["Conclusion"];
The study suggests that while both solid and cannulated interlocking nails are effective for fracture union and have similar infection rates, solid nails offer superior strength and a lower risk of implant failure. Potential reasons for the higher failure rate in cannulated nails include differences in stiffness and material quality.
- There was no statistically significant difference in union time or infection rates between the solid and cannulated interlocking nail groups (p > 0.05).
- There was a statistically significant difference in implant failure between the two groups, with no failures in the solid nail group (Group A) and four failures in the cannulated nail group (Group B) (p < 0.05).
- Solid interlocking nails were found to be stronger than cannulated ones.
- Road traffic accidents were the most common cause of femoral shaft fractures, predominantly affecting the male adult population.
Solid interlocking nails are stronger than cannulated interlocking nails, leading to a significantly lower rate of implant failure. There is no significant difference in union or infection rates between the two types of nails.
- Study duration: January 2007 to December 2008. (Confirmed by text)
- Number of patients: 60 patients, with 30 in each group. (Confirmed by text)
- Union within 3 months in Group A: 26 out of 29 united patients (86.66%). (Confirmed by text)
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