Comparative Efficacy of Intramedullary Nailing and Plate and Screw Fixation in Femoral Shaft Fractures: A Prospective Study of 40 Patients

Abstract

Background: Femoral shaft fractures are a significant cause of morbidity and require effective orthopedic management to ensure optimal outcomes. Two prevalent modalities for the surgical treatment of these fractures are intramedullary nailing and plate and screw fixation.

Aim: This study aims to compare the efficacy, outcomes, and complications associated with these two surgical techniques in the treatment of femoral shaft fractures.

Patients and Methods: This prospective study involved 40 patients with femoral shaft fractures who were randomly assigned to undergo either intramedullary nailing (n=20) or plate and screw fixation (n=20). The patients were followed for a period of 12 months. Outcome measures included time to union; functional recovery assessed using the Harris hip score, and the incidence of complications.

Results: Twenty of the forty patients had plate and screw fixation, and the other twenty underwent intramedullary nailing. When comparing the intramedullary nailing group to the plate and screw fixation group, the mean time to union was substantially shorter (p<0.05). In the intramedullary nailing group, the hip scores at 6 and 12 months after surgery were significantly higher. There was a discernible difference in the prevalence of infection and non-union between the intramedullary nailing group and the plate and screw fixation group in terms of complication rates.

Conclusion: Intramedullary nailing is a more effective and reliable method for fixing femoral shaft fractures, offering faster bone healing, better functional outcomes, and lower complication rates. It should be the preferred treatment for suitable patients, with further large-scale studies recommended.