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.
Citation
Masters of Medicine (Surgery)Publisher
University of Nairobi School of Medicine