Original Research Article
Year: 2023 | Month: April-June | Volume: 8 | Issue: 2 | Pages: 395-404
DOI: https://doi.org/10.52403/ijshr.20230250
Treatment of Open Femur Fracture of the Gunshot Injuries by Interlocking Nail in Aden, Yemen
Omar Abdulsalam Abdullah Hadi Mohsen
Orthopedic Resident, Algamhoria Teaching Hospital and Alsalam Hospital, Aden, Yemen
ABSTRACT
Background: Gunshot wounds remain a major clinical problem with bone injuries.
Objective: To evaluate the treatment procedures of open fractures due to gunshot and the outcome
Patients and methods: This was a prospective study conducted during January 2019 to December 2020.
The enrolled patients were males having open fracture of femur due to gunshot or explosive shrapnel injuries and the data collected directly from patients by interview. The fractures were classified according to Gustilo classification.
All patients underwent with stainless steel intramedullary nail with proximal and distal screws.
Follow up of patients was for six months. Data were processed using the SPSS, version 22. Fisher test was used and p-value < 0.05 was considered as statistically significant.
Results: The study cases were 62 male patients. Age ranged between 17 to 50 years and the mean age was 25.7 ± 7.2 years. Gustilo open fracture type 3A seen in (98.4%) patients. Most of the site of femur fracture was at mid shaft (67.8%).
Half of patients (53.3%) had time interval of first debridement within 7 – 12 hours,
Predominantly debridement was performed once in (82.4%) patients.
Mostly, delayed primary closure was carried out within 3 – 7 days in (71%) patients. IM nail was carried out mostly (56.6%) of cases within 7-14 days.
We found superficial infection and acute osteomyelitis each one in (6.5%) patients.
Pulmonary embolism found in (3.2%) patients. Deep wound infection, chronic osteomyelitis, deep vein thrombosis, each one was in (1.6%) patient.
We found shortening in (1.6%) patient, mal-union in (1.6%) patient, non-union in (3.2%) patients and stiffness found in (3.2%) patients.
Conclusion: Intramedullary nailing provide an effective device in patients with gunshot fractures of femur and it is safe and provides strong fixation, rotational stability and earliest return to functional status.
Keywords: Open femur fracture, gunshot injuries, interlocking nail