Abstract:

BACKGROUND: The upper femoral shaft fracture is clinically treated with internal fixation with metal implant. However, complications occur due to fracture type, operative and internal fixation method or functional exercise postoperatively. There are few reports on the upper femoral shaft following fracture internal fixation system complications and their causes.
OBJECTIVE: To observe the clinical results and complications in the upper femoral shaft fracture following different internal fixation methods.
METHODS: A total of 92 cases of femoral shaft fractures were selected from Department of Orthopedics, Boji Hospital of Zhongshan University, including 63 males and 29 females, aged 18 to 65 years. They were randomly divided into 3 groups, and respectively treated with interlocking intramedullary nail fixation with Internal fixation group, Compression plate Internal fixation group, Plum nail Internal fixation group, Three groups using the same surgical approach and the conventional internal fixation, 3 groups were observed after surgery in patients with conditions, early complications, long-term complications, clinical, follow-up.
RESULTS AND CONCLUSION: The 92 patients with the upper femoral shaft fractures were successfully treated with open reduction and internal fixation. The average success rate and the operation time displayed no significant difference among the groups (P > 0.05). The fracture healing time was less, but the cure rate was greater in interlocking nail group and plate fixation group than plum nail group (P < 0.05). The upper femoral shaft fracture, implant bending fracture, fracture nonunion, re-fracture and infection were major complications. Incidence of complications in interlocking intramedullary nail fixation group was lower than the compression plate fixation and plum nail groups (P < 0.05). Results show that interlocking intramedullary nail fixation facilitated fracture healing, but different fracture site and types, and various fixator material intensity and reduction conditions, the individualized treatment should be performed to prevent or reduce complications.