Results of the treatment of femoral and tibial fractures following interlocking nailing and plate osteosynthesis. A comparative retrospective study

The Howmedica lock nail was introduced to an ordinary hospital where femoral and crural fractures had been stabilised in the past almost exclusively by plate-type osteosynthesis. Since only minor change had taken place regarding surgeons and surgical environment, the decision was taken to compare two groups of patients with lock nailing and plate-type osteosynthesis. Most of the nailing patients could immediately expose the injured extremity to load. Hospitalisation for them was as short as twelve days on average. They were fit for work not later than six months from surgery. Plate-type osteosynthesis patients, on the other hand, were hospitalised five weeks, on average. None of the patients could fully use his or her leg, after two months. Pseudoarthrosis was quite frequent in the wake of plate-type osteosynthesis but was not observed at all after lock nailing. The risk of posttraumatic osteomyelitis was considerably reduced. Covered nailing proved to be applicable to the majority of cases. A specifically designed image converter was used in cases of distal locking. Lock nailing proved to provide a great number of advantages, with cost saving being one of them. It is a routine method that can be used at any general hospital, once the surgical team on the spot has been familiarised with the technique.