Comparative Clinical Study Between Plating and Intramedullary Nailing of Femoral Shaft Fractures in Adult

Lee, Young Sik; Choi, Kyung Soo; Choung, Eu Sub; Yang, Sung Su

Abstract

Various methods have been used in the treatment of femoral shaft fractures in adults. In recent years, generally accepted two methods are intramedullary nailing and plate fixation. We followed and reviewed 121 cases of femoral shaft fracture in 116 patients, treated by operation in Orthopaedic Department, Presbyterian Medical Center, Chonju from 1980 to 1986. All cases were devided into 2 groups, intramedullary nailing(24 cases) and plate fixation (97 cases), and the two groups were compared each other. The results are as follows : 1. Most of intramedullary nails were used in relatively younger age group, before 50 yesrs of age. 2. The mean bony union time in plate fixation was 14 weeks and that in intramedullary nailing was 17.4 weeks. They showed about 3 weeks of difference. 3. In the group, whose operations were performed within 2 weeks after injury, showed high rate of bone union within 6 months, but in those whose operations were delayed more than 2 weeks showed marked decrease in bone union. And the rate of decrease was greater in plate fixation. 4. The recovery of knee joint motion above 110 was greater in intramedullary nailing (87.5%) than that in plate fixation(79.3%). 5. There was no difference in functional recovery between plate fixation and intramedullary nailing. 6. The complications, including delayed and nonunion, infection, metal failure, and limitation of knee joint motion, were more in plate fixation. 7. The risk of refracture is higher in plate fixation. Therefore plates must be removed after some period.