Functional Outcomes of Femoral Shaft Fracture S Treated with Intramedullary Nailing and Plate Osteosynthesis in Adults – A Comparative Study
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Abstract
Background:
Femoral shaft fractures, often caused by high-energy trauma such as motor vehicle accidents and falls, are severe injuries that require effective treatment to restore function and ensure mobility. The two main surgical interventions for these fractures are intramedullary nailing and plate osteosynthesis. While both methods are widely used, their comparative efficacy in terms of functional outcomes, radiological healing, and complication rates remains an area of ongoing research.
Objective:
This study aims to assess and compare the functional and radiological outcomes of femoral shaft fractures treated with intramedullary nailing versus plate osteosynthesis in adult patients. The incidence of postoperative infections associated with each method was also evaluated.
Methods:
An observational study was conducted over 18 months at Sree Balaji Medical College, involving 25 patients aged 18-70 years with femoral shaft fractures. The patients were divided into two groups: Group A (n=12) received plate osteosynthesis, and Group B (n=13) underwent intramedullary nailing. Clinical outcomes, radiological union at 20 weeks post-surgery, and infection rates were tracked. Statistical significance was determined using a p-value threshold of 0.05.
Results:
Intramedullary nailing led to significantly better functional outcomes, with 61.5% of patients achieving excellent results compared to 25.0% in the plating group (P-value = 0.04). The nailing group also experienced faster radiological union, with a mean of 20 weeks compared to 22 weeks for the plating group (P-value = 0.02). Infection rates were higher in the plating group (33.3%) compared to the nailing group (15.4%), though this difference was not statistically significant (P-value = 0.21). Road traffic accidents were the most common cause of injury in both groups.
Conclusion:
Intramedullary nailing provides superior functional outcomes, faster healing, and lower infection rates compared to plate osteosynthesis for femoral shaft fractures. While plate osteosynthesis is necessary for more complex fracture patterns, intramedullary nailing offers better overall recovery, particularly in cases that benefit from less invasive techniques and quicker mobilization. These findings support the preferential use of intramedullary nailing in the management of femoral shaft fractures.