DefinePK

Abstract

Static I /M I/L Nailing is considered to be the gold standard for fixing mid-shaftfractures of long bones. Flexible nails or plates are used in children for internal fixation of suchfractures to avoid damage to epiphysis. Nailing is done under image intensifier using orthotable.These prerequisites are not available in all peripheral hospitals especially in a resourceconstrained country like Pakistan. A technique was evolved to do static I/M I/L Nailing withoutimage and ortho-table while working under such conditions at MASH at CMH Muzaffarabad.The results were compared with the procedure done under image by the same surgeon.Study Design: Retrospective comparative study. Settings: Field Hospital (MASH) at CMHMuzaffarabad, CMH Kharian, CMH Malir and CMH Nowshera. Period of Study: Sep 2007 toMarch 2016. Material and Method: 165 cases of fracture femur, tibia and humerus were fixedwith static I/M I/L Nailing without image intensifier while 148 cases of fractures of these bonesfixed under image using ortho -table by the same surgeon were included in the study. Results:A minimum follow-up of 06 months was done and observations made regarding estimatedblood loss, average time of operation (including anesthesia), and fracture healing time, weightbearing, early and late complications. Results are compared in two groups. Conclusion: I/M I/LNailing for long bones fractures can be done without image intensifier11 or any intra-operativeX-rays.4 Ortho-table is also not essential. Technique is simple. Opening the fracture site is notrequired in most of the cases. Minimal access is used when fracture site opening is required. Itdoes not compromise any principle for internal fixation. Distal interlocking screws are appliedwithout making a cortical window and their position is doubly confirmed intra-operatively bya simple technique (not mentioned in literature before this study). There are no added risksinvolved12 and results are comparable to the procedure done using image intensifier and orthotable.