Intelocking versus kuntscher nails in the management of femoral shaft fractures

To compare the outcome of Femoral shaft fractures managed with Interlocking and Kuntscher intramedullary nails, in terms of healing time, full weight bearing and post-operative complications. Prospective, quasi-experimental study from March 1999 to May 2002. Orthopaedics Unit I, Civil Hospital, Karachi. A total of 200 cases of Femoral shall fractures. Half [100] the cases of Femoral shaft fractures were treated with Kuntscher intramedullary nails and the other half [100] with Interlocking nails, the cases being assigned randomly. The detailed data of the patients was recorded, computed and analyzed using Chi-square test and Students t-test. The main parameters compared included fracture healing time, full weight bearing time and post-operative complications. There was no significant difference between the two groups in terms of demographic data, fracture type and associated co-morbidities. The average operating time was 110 +/- 25 minutes for the Interlocking nail and 80 +/- 15.8 mins for the K-nail. All patients of K-nail group needed blood transfusion, while only 17 patients of interlocking group needed blood transfusion. The fill weight bearing time was significantly shorter [p < 0.005] in cases of Interlocking nail. Out of 200 fractures 182 [91%] healed with in six months while 18 [9%] did not. The latter included 6 [3%] cases treated with Interlocking nails and 12 [6%] with Kuntscher nails, p < 0.005. Interlocking intramedullary nailing is better than Kuntscher nailing in every respect

Intestinal perforation experience in 80 cases

Eighty patients ranging from 10-60 years were treated for Intestinal perforation. Seventy one [89%] were males. Mortality rate was 15%, and was influenced by duration of illness, duration of perforation, shock, uraemia and faecal peritonitis. Seventy four patients were treated by simple closure of perforation, four required right hemicolectomy and two were in terminal stage and were intubated under local anaesthesia. 56 patients [70%] had post-operative complications