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VOL. 3, ISSUE 2 (2021)
Interlocking screw breakage following intramedullary nailing of femur and Tibial shaft fractures
Authors
Shekar M, M Devendra, Sachin Katti
Abstract
Introduction: Interlocking nailing potentially is complicated by failure of the hardware around the nail aperture for distal metaphyseal fractures, communited fractures, fractures with delayed union, and fractures with small nails. For many reasons, broken screws occur most often after static interlocking of femur & tibia. Fatigue failure causes bending & breakage of the screws. Aim: The purpose of this study is to find the causes for breakage of screws after analyzing the fracture type, pattern, level & type of nail & screws used. Type: Retrospective study. Method: 460 cases of reamed interlocking nailing of tibia & femur done from May 2015 to February 2018 at our institution. 30 cases with interlocking screw breakage were studied. 26 cases were males & 4 cases were females with mean age group of 38 to 48 years. 18 cases were tibia & 12 cases were femoral interlocking. Results: Average time of screw breakage was 12.5 weeks. Delayed union was seen in 7 cases, nonunion in 3 cases, 16 cases fracture was uniting well, two cases significant gap was seen immediate postoperatively & in 2 cases fracture had united prior to screw breakage. Dynamization was done in 5 cases before screw breakage & bone grafting in 4 cases. Distal locking was done with 2 screws in 5 cases. Screw near to fracture site was broken in 15 cases, one case distal one of distal screws, 2 cases both proximal & distal screws were broken. One case both distal screws were broken. 4.5 mm screws of two different companies X & Y were used. In 26 cases X screws have broken & in 4 cases Y screws have broken. Conclusion: From our study we conclude that hardware failure after interlocking nailing of femur & tibia can be prevented by using appropriate size of nail with good cortical contact. Two distal locking screws must be used in Winquist type 3 & 4 fractures. The screw must be inserted properly at appropriate location from fracture site. Protected weight bearing should be done in severely comminuted fractures. Better quality screw with good strength must be used. Dynamization may not prevent from screw breakage.
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Pages:01-04
How to cite this article:
Shekar M, M Devendra, Sachin Katti "Interlocking screw breakage following intramedullary nailing of femur and Tibial shaft fractures ". International Journal of Orthopaedics Research, Vol 3, Issue 2, 2021, Pages 01-04
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