Locked nailing of the femoral diaphysis at the laquintinie hospital in Douala

Abstract

Introduction: Femoral shaft fractures in adults are common and serious. Intramedullary nailing is the treatment of choice and is ideally  performed on a surgical table with an orthopaedic extension. Without the latter, our patients could be exposed to complications, which  could compromise functional recovery. The aim of this work was to evaluate the anatomical and functional outcome after locked nailing  of the femur at the Laquintinie Hospital in Douala.

Materials and methods: It was a descriptive study with a retrospective collection of data over 3 years to evaluate the outcome of our substitution practice at Laquintinie Hospital in Douala.

Results: 84 patients were included in our study. The mean age was 35.4 years. There were 56 males and 28 females. 73% of the fractures  occurred following a road traffic accident, of which a motorbike was involved in 89% of the cases and the patient was a passenger 75% of  the times. The fracture was located in the middle third of the femoral diaphysis in 70% of cases, and the fracture line was comminuted in  65% of the cases. We did not have any pseudoarthrosis in our series. However, there were 29 malunion cases: 7 varus less than 10 degrees, 25 shortenings of which 21 were between 2 and 4 centimeters, and 4 greater than 4 centimeters. In terms of recovery, our  average follow-up was 14.6 months (6-30 month) and according to Thorensen's score, 88% of the results were satisfactory, i.e. 67% good  and 21% average. 

Conclusion: In adults, locked nailing on an ordinary table is a reliable and simple technique. It gives satisfactory results  in fractures of the femoral shaft. It is recommended in our countries given our limited resources.