Interlocking Intramedullary Nailing of the Femoral Shaft Fracture: A Comparison between Gross-Kempf Nail and Interlocking Compression Nail

Kim, Ki Soo; Choi, Yong Soo; Lim, Chae In; Chung, Yang Min

Abstract

Various designs of interlocking intramedullary nailing systems allowing closed nailing techniques have been used in the treatment of femoral shaft fractures, but there are little objective data available to compare their performance. The authors reviewed 58 patients of femoral shaft fractures which were treated at Kwang ju christian hospital from April 1992 to June 1994. The Gross-Kempf nail was used in 39 patients and the Interlocking compression nail was used in 19 patients. The purpose of this study is to determine if there are any significant difference in the application, ease of use or clinical outcome. The average follow up period up period was 21.5 months (range 12 to 31 months) and the results were as follows. 1. Two nails have similar indication for use, but G-K nail was more satisfactory for proximal fractures of the femur and I-C nail was used as a compression nail with application of one proximal interlocking screw in oval hole in simple stabilizable fractures(Winquist Hansen type I and / or type II). 2. In the G-K naiBing group, the partially threaded screw of distal locking gaining purchase in only one cortex comes loose more often and backs out more frequently. In the I-C nailing group, the fully threaded screw of distal locking is able to fail of screw because of smaller core diameter of the screw. Successful distal locking is not only dependent upon strength of transverse screw, but also upon achieving cortical fixations with threads. 3. Complications seemed to be failure of operative principle and postoperative care rather than any intrinsic problems with the nail themselves.