Factors Affecting Implant Failure in Fracture of the Shaft of Femur

Abstract

17 cases of implant failure of fracture of shaft of femur were studied. All cases were young adults less than 40 years of age. 15 were males. 16 of 17 cases sustained their initial injury in road - traffic accidents. Plate failures were detected earlier than those of nails as nails kept on providing splintage to an otherwise ununited fracture. 10 of 17 cases were treated by interlocking nailing during the resurgery. Cortico-cancellous bone grafting was done in 9 of 17 cases as per merit of each case. Follow-up ranged from 6 months to 2 years. 15 of 17 cases went on to sound union after the second operation. The wrong choice of implant, implants improperly applied and bone grafting not done as recommended (i.e. technical errors) is the major cause of implant failure. Nails with diameter more than 10 mm should be used as far as possible. Early detection and resurgery for K-nail failure should be done to prevent greater amount of shortening. Wherever plating is done, instead of attempting anatomic reduction and devascularising the bone, biological method of fixation should be used. Key Words: Implant Failure, Shaft of Femur, Fracture.