A Study Of Fractures Of The Femoral Shaft Treated By Intra-medullary Nailing At The Kenyatta National Hospital Over A Five Year Period

Abstract

'This is a partly retrospective and partly prospective study covering the five year period from January 1st 1975 to December 31st, 1980; examining the clinical profile of 'the patients who had intramedullary nailing for femoral shaft fractures. The indications for medullary nailing are reviewed and an attempt is made to show that, the incidence of complications ,following this operation rises sharply when intramedullary nailing is done when not indicated. Of 108 patients in the study 92% sustained their fracture in a road traffic accident, 90% of these patients were male. The majority between the ages of 15 - 40 years. A high incidence of serious associated injuries is noted, the efficacy of intramedullary nailing in easing the suffering and simplifying .the nursing care of these patients is noted. A point is made that in fractures of the femoral shaft, associated skeletal and Visceral injuries' must always be looked for and treated: The complicatlons of this method of fracture treatments are tabulated, together with their possible aetiological factors and their management. The rate.of infection was found to be 5%, suggestion are made, on how to further. reduce the infection rate.

Other complications are noted to be of a minor nature, mainly due to technical errors in the operative technique:-) mainly improper reaming and wrong nail size selection. Suggestions are made in order to minimise the. incidence of these complications. It is concluded that intramedullary nailing is an effective method of treatment, that it is safe and relatively easily learned and can be used even more extensive at the District Hospital level, subject to the recommendations made above.