Evaluation of results after dynamization of interlocking nail in diaphyseal fractures of femur and tibia

Abstract

Dynamization could be achieved by provision of oblong slots in the intramedullary nails called as dynamic holes, along with the circular slots. Thereafter the process of dynamization was done that included removal of the screw in the circular slot (static hole) after 6-12 weeks of surgery when the soft callus had already formed that allowed the interlocking screw in the dynamic hole to move about in the axial direction thus conferring a dynamic compression at the fracture site during weight bearing. Patients were examined, haemodynamically stabilised, 1 st aid administered in the form of splintage/ traction/ POP slab along with analgesics followed by radiological evaluation. Relevant data was recorded in preprepared proforma. Patients were evaluated clinically for fitness for anesthesia and surgery. Relevant investigations were done. Out of 77 femoral interlocking nailing procedures, in 6 cases, the fracture got impacted on table itself and thus nailing was done in dynamic mode since the very beginning, while another 8 cases underwent dynamization subsequently between 6-12 weeks post-op. Patients were followed up and when 2 consecutive x-rays did not show progress of union, were subjected to dynamization.