OPEN KUNTSCHER NAILING OF FEMUR SHAFT FRACTURE- ITS RELEVANCE IN PRESENT ERA OF INTERLOCK NAILING

Abstract

BACKGROUND Femur shaft fracture is a common injury seen in road traffic accidents and other high energy trauma. Kuntscher nailing was a popular method of fixation before interlocking intramedullary nail has come into practice. However, in certain situations where interlocking nail cannot be used, the role of Kuntscher nail is still a method to fix the fracture. MATERIALS AND METHODS This retrospective descriptive study was done to evaluate the relevance of Kuntscher nailing in femur shaft fracture against the interlocking intramedullary nail with regard to union, complication, return to work place. We retrospectively reviewed 73 patients with fracture shaft of femur treated with open Kuntscher nailing. Patients were discharged from the hospital after 14 days of surgery usually after removal of stitches. RESULTS All fractures healed within 16-24 weeks and the union rate was 96% (95.89). 4 patients developed superficial wound infections. 3 had limb shortening of 1-2 centimeters and range of motion at the knee from 0 to 130 degrees at minimum 6 months follow up. There were no rotational deformities. 1 patient had bent nail because of early mobilization and 2 broken nails leading to nonunion. 54.79% (n=40) belonged to low socio-economy group and 6.8% (5) had medical co-morbidity. CONCLUSION Open Kuntscher nailing for fracture shaft femur is still a relevant surgery in the developing worlds, especially in a government set up where low socio-economic group patients form a major chunk of in-patients. It is found that K-nailing gives better functional and clinical results where interlocking nailing can't be done.