Dhakal Amar Prasad, Awais Syed Muhammad
Department of Orthopaedics, Nepal Medical College, Jorpati, P.O. Box: 13344, Kathmandu, Nepal.
Nepal Med Coll J. 2003 Dec;5(2):73-8.
A prospective and comparative study of 44 cases of close locked static intramedullary (IM) nailing of Femur shaft fracture with two nailing systems was done. Comparing the cheap predrilled Kuntscher nail with standard but expensive Variwall nail of Biomet Company England, we found almost equal result in both groups regarding complications and healing of the fracture. Average healing time in Variwall and Kuntscher nailing were 16.4 and 16.1 weeks respectively, P value being in-significant. In Variwall nailing, stable fractures healed at the average of 13.5 weeks and unstable fractures at 17.2 weeks; open fractures at 18.4 weeks and close ones at 14.2 weeks; fractures due to Road Traffic Accident (RTA) at 16.3 weeks, gunshot injury at 18.6 weeks and fractures due to fall at 14 weeks. Similarly in Kuntscher nailing these figures were 14 and 16.7 weeks; 19.6 and 14.5 weeks; 16.6, 22 and 13 weeks respectively. Pre-drilled Kuntscher nail with good quality cortical screws for interlocking is recommended for any variety of femoral shaft fracture. It is cost effective, at the same time gives acceptable result as compared to standard interlocking intramedullary nail.
对44例股骨干骨折采用两种髓内钉系统进行闭合锁定静态髓内钉固定的前瞻性对比研究。将廉价的预钻孔Kuntscher钉与英国Biomet公司标准但昂贵的Variwall钉进行比较，我们发现两组在骨折并发症和愈合方面的结果几乎相同。Variwall钉和Kuntscher钉固定的平均愈合时间分别为16.4周和16.1周，P值无统计学意义。在Variwall钉固定中，稳定骨折平均在13.5周愈合，不稳定骨折在17.2周愈合；开放性骨折在18.4周愈合，闭合性骨折在14.2周愈合；交通事故导致的骨折在16.3周愈合，枪伤导致的骨折在18.6周愈合，跌倒导致的骨折在14周愈合。同样，在Kuntscher钉固定中，这些数字分别为14周和16.7周；19.6周和14.5周；16.6周、22周和13周。对于任何类型的股骨干骨折，推荐使用带有用于交锁的优质皮质骨螺钉的预钻孔Kuntscher钉。它具有成本效益，同时与标准交锁髓内钉相比，能给出可接受的结果。
