ASSESSMENT OF THE RESULTS OF USING A MODIFIED KUNTSCHER NAIL AS A STATIC INTERLOCKING NAIL IN THE MANAGEMENT OF FEMORAL SHAFT FRACTURES

Abstract

Femoral shaft fractures are a major cause of morbidity and mortality and they have an extensive history of many methods of care. Intramedullary fixation is suitable for the straight anatomy of the femoral shaft: Locking of the fracture fragment to the nail eliminates the problems of shortening and malrotation.

In this series, locking holes were made in the simple Kuntscher nails and these nails were used in 17 patients with femoral shaft fractures who can not afford other expensive locking systems. Dynamization was done after 5 month in 2 patients (11.8%) to hasten bone healing. The results were satisfactory in 15 patients (88.2%) and unsatisfactory "poor" in 2 patients (11.8%). Broken drill, missed screws, increased comminution at the fracture site and broken screws were the technical complications that appeared with the use of the modified Kuntscher nail. Broken nail was recorded only in one patient (5.8%) who had early weight bearing.

We concluded that modified Kuntscher nail could be used as a static interlocking nail in patients who can not afford other expensive interlocking systems keeping in mind that delayed weight bearing is mandatory till adequate callus forms.