Reamed versus unreamed nailing for femoral shaft fractures.

Dr. Dev Reshi Kumar Pandey; Dr Kuldeep kumar Gogia; Dr. Mohammad Zakiuddin

Volume : VIII, Issue : VII, July - 2019

Reamed versus unreamed nailing for femoral shaft fractures.

Dr. Dev Reshi Kumar Pandey, Dr Kuldeep Kumar Gogia, Dr. Mohammad Zakiuddin

Abstract :

BACKGROUND: Stabilization of fractures with an intramedullary nail is a widespread technique in the treatment of femoral shaft fractures in adults, however to ream or not to ream is still being debated. Intramedullary nailing is the mainstay of treatment femoral shaft fractures. AIMS AND OBJECTIVE: The primary objective of this study was to determine clinical results following Unreamed versus ream intramedullary nailing of femoral fractures. METHODS AND MATERIALS: Between November 2016 to December 2018, 100 patients with femoral shaft fractures were treated with Unreamed or reamed femoral nails in G.S Medical College and Hospital, Hapur. From this prospective single centre study, 18 patients were excluded due to insufficient follow-up data. According to the AO Classification, fractures in this study were either type A or B. Dynamic proximal locking was performed in all cases. The remaining 82 patients were divided in to two groups of 41 with ream or Unream nailing. RESULT: There were no differences in radiologic union time. (p=1) or full weight be� time (p=0.74) between ream and Unream nailing. In the ream group surgical time was about thirty minutes longer and differences were significant (p=0.000). We found no statistical difference between union time with or without reaming. On the other hand, there was significant increased operation length, blood loss and systemic changes in BP or So2 in the ream group versus the Unream group. We also had pulmonary complication and radiation exposure in reamed group. CONCLUSION: Unream nailing in traumatic femoral shaft fractures is a simple, safe and effective procedure with significant advantages, especially in multitrauma patients.