Locked Intramedullary Nailing of Fractures. Experience from a Trauma Centre in Nigeria: A Prospective Observational Study

Abstract

Background: Locked intramedullary nailing of fracture has evolved as the gold standard for the treatment of fractures of the shaft of the long bones. It provides axial loading, controls length, alignment and rotational deformities of the injured limb. It also allows for early mobilisation of the patient. The procedure of locked intramedullary nailing is associated with many changes including logistics, expertise and cost for the instrumentation and the implants. This study aimed to highlight the experience of locked intramedullary nailing of long bones fractures from a regional trauma centre in Nigeria. Methods: Prospectively collected data on long bone fractures treated by locked intramedullary nailing from January 2007 to December 2012 were analysed and presented. Results: Eight hundred and seventy-three long bone fractures were treated by locked intramedullary nailing during the period. Majority of the patients were males with the mean age of 28.6 years ± 12.2 years. Most of the fractures resulted from road traffic crashes 657 (75.3%), and the majority of the fractures were closed 648, (74.2%). Eight hundred and eleven (92.9%) of the fractures were reduced using the open approach. Six hundred and eighty of the fractures treated by this method had shown radiological evidence of fracture union at six months after surgery, and the recorded infection rate was 46 (4.8%). Conclusion: Locked intramedullary nailing is a good option for treatment of the shaft of long bones in a resource-scarce environment.  The method showed good outcome with acceptable complication rates.