Objective: To assess the outcome of dynamization in delayed union of femoral shaft fractures treated initially with static interlocking nailing.
Study Design: The descriptive case series study.
Place and Duration of Study: The study was carried out at the Department of Orthopedic Surgery Jinnah postgraduate medical centre Karachi, from May 2016 to Feb 2017.
Material and Methods: Forty-two patients were included in this study who showed delayed healing of femur fractures from six weeks to six months after initial treatment with static interlocking nailing. Full weight bearing was allowed immediately after dynamization. Rests of the cases were treated with exchange nailing or cancellous bone grafting with or without lengthening and achieved satisfactory outcomes. The patients were followed up for at least 9 months and serial radiographs were taken.
Results: Most of the patients (71.4%) were between 15 to 30 years of age. The average age of the patients was 26.6 ± 9.6 years (both males & females). Out of 42 patients, 30 (71%) patients were male and 12 (29%) were female with 2.5:1 male to female ratio. The mean age for males was 25.05 ± 7.5 years whereas the mean age for females was 28.14 ± 6.4 years. Twenty six patients (62%) achieved a solid union with a union period of 21.67 ± 2.5 weeks after dynamization. 6 of 26 patients who achieved solid union developed femoral shortening of 1 cm to 2cm.
Conclusion: Dynamization is a simple, day case method that can be tried to improve fracture healing in femoral shaft fractures that show delayed healing after interlocking nailing with a less developed problem of 1 to 2 com shortening.
Keywords : Dynamization delayed healing, Femur fracture, Interlocking nailing, Solid union.