Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Original article / research
Table of Contents - Year : 2017 | Month : August | Volume : 11 | Issue : 8 | Page : RC04 - RC06

Closed External Fixation for Failing or Failed Femoral Shaft Plating in a Developing Country RC04-RC06

Adil aliakbar, Ibrahim . Witwit, Alaa A.Hussein Al-Algawy

Dr. Adil Aliakbar,
College of Medicine, Aljamiaa Street, Al-hilla-00964, Babil, Iraq.

Introduction: Femoral shaft fractures are one of the common injury that is treated by open reduction with internal fixation by plate and screws or intramedullary nailing which achieve a high union rate.

Aim: To evaluate the outcome of using closed external fixation to augment, a failing plate, with signs of screws loosening and increasing bone/plate gap, a failed plate, broken plate or screws completely out of bone with redisplacement of fracture.

Materials and Methods: A retrospective study of 18 patients, aged between 17-42-year-old, were presented between 6-18 weeks after initial surgical fixation, with pain, difficulty in using the limb, deformity and abnormal movement at fracture site. X-Rays showed plating failure with accepted amount of callus but unfortunately refractured , with deformity. Cases associated with revealed infection and no radiological evidence of callus formation were excluded from this study. Closed reduction by manipulation was done then fracture fixation by AO external fixation. The patients were encouraged full weight bearing as early as possible with dynamization later on.

Results: Of the 18 patients who underwent external fixation after close reduction,15 cases ended with bone healing in a period between 11-18 weeks (mean of 14.27 weeks) in good alignment (X-Ray evaluation) and removal of external fixation was done followed by physical therapy.

Conclusion: Closed external fixation for treatment of failing or failed femoral plating, achieve good success rate, less complications, short time of procedure, especially in a hospital of limited resources.