Search

BACKGROUND: Accurate and rapid insertion of distal locking nail of femoral intramedullary nail is still a difficult problem. The distal locking accuracy of common intramedullary nail is low, with long time-consuming and intensive radiation. OBJECTIVE: To investigate the characteristics and efficacy of intramedullary nailing with core drill distal locking system in the treatment of adult femoral shaft fractures. METHODS: From January 2014 to December 2016, patients with femoral shaft fracture undergoing treatment of supine position with anterograde intramedullary nail in the Third Affiliated Hospital of Anhui Medical University were retrospectively analyzed. They were treated with core drill distal locking system intramedullary nail(n=21; observation group) and common intramedullary nail(n=17; control group). Both groups of patients signed informed consent to the treatment and trial plan. This study was approved by the Hospital Ethics Committee. The clinical effects of the two groups were compared. RESULTS AND CONCLUSION:(1) Compared to the control group, the operation time was shorter [(191.76±25.04) minutes vs.(156.90± 23.36) minutes]; the distal locking operation time was shorter [(1 223.47±165.92) seconds vs.(497.19±82.78) seconds]; the fluoroscopy times were less [(22.18±3.05) times vs.(12.81±2.64) times]; the blood loss was less [(371.18±129.42) mL vs.(192.86±83.13) mL]; location accuracy rate of distal locking nail was high [79.41% vs. 95.24%] in the observation group, showing significant differences(P < 0.05).(2) The healing time of fracture was similar and the functional recovery of hip and knee joint was similar between the two groups(P > 0.05).(3) All cases were followed up for 14 to 27 months. No fracture of internal fixator occurred. All patients achieved bone healing.(4) In the observation group, one case had superficial infection, which healed well after strengthening dressing change and anti-infection treatment. In the control group, one case had superficial infection, and the fracture healed well after strengthening dressing change and anti-infection treatment. One case of distal screw loosening was not treated specially, and the healing was achieved by prolonging the loading time and follow-up time.(5) It is indicated that core drill distal locking intramedullary nail for femoral shaft fracture has shorter locking operation time, higher accuracy, fewer fluoroscopy times, less blood loss during operation. The clinical effect is satisfactory. [ABSTRACT FROM AUTHOR]