Key result
Treatment of diaphyseal femoral fractures with an intramedullary interlocking nail in the lateral decubitus position resulted in 55% excellent and 27.5% good outcomes according to Thoresen's criteria.
Why the study?
Conventional supine positioning on a traction table for diaphyseal femur fractures carries risks such as compartment syndrome and pudendal nerve palsy, which might be avoided in the lateral decubitus position.
Does intramedullary interlocking nail fixation in the lateral decubitus position provide favorable outcomes in adults with diaphyseal femoral fractures?
Observational (n=40)
No
Does intramedullary interlocking nail fixation in the lateral decubitus position provide favorable outcomes in adults with diaphyseal femoral fractures?
Fixation of femur diaphyseal fractures in the lateral decubitus position with an intramedullary interlocking nail yields excellent or good functional outcomes in 82.5% of patients while providing easy access to the proximal femur.
Lateral decubitus femoral nailing showed mostly excellent/good outcomes; leaves open comparative safety versus traction table in randomized trials.
Background: The diaphyseal fractures of femur in adults are conventionally treated in supine position on traction table, which carries risk of compartment syndrome, pudendal nerve palsy, whereas in lateral decubitus position these complications can be avoided with additional advantage of easy access to greater trochanter particularly in obese patients. The aim of this study is to evaluate outcomes of femur diaphyseal fractures treated with intramedullary interlocking nail in lateral decubitus position. Methods: In this study 40 patients with femur diaphysea fractures were treated with intramedullary interlocking nail in lateral decubitus position, were studied for a period of 9 months from September 2019 to May 2020. Results: At the end of our study of 40 patients, outcome is graded according Thoresen’s criteria where 22 (55%) patients had excellent results with full, pain-free, function of the extremity and 11 (27.5%) patients had good result; 10 patients had range of motion 1200 and shortening of femur by 1.5 was observed in 1 patient. There were 6 (15%) patients with fair result; with range of motion 900 and 1 poor result (2.5%) had non-union with range of motion <900. Conclusions: Fixation of femur diaphyseal fracture in lateral decubitus position leads to easy access to the proximal femur making it easy to establish an entry point for an intramedullary device and it significantly eliminates the complications caused by other conventionally used methods.
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Haque et al. (2021) conducted an observational in Diaphyseal femoral fractures (n=40). Intramedullary interlocking nail in lateral decubitus position was evaluated on Clinical outcome according to Thoresen's criteria (excellent result). Treatment of diaphyseal femoral fractures with an intramedullary interlocking nail in the lateral decubitus position resulted in 55% excellent and 27.5% good outcomes according to Thoresen's criteria.
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