OUTCOME OF STATIC VERSUS PRIMARY DYNAMIC CLOSED ANTEGRADE REAMED INTRAMEDULLARY INTERLOCKING NAIL IN FEMORAL SHAFT FRACTURES: A PROSPECTIVE COHORT STUDY

ABSTRACT OBJECTIVES This study aimed to compare fracture-healing rates in short oblique and transverse femoral shaft fractures treated with closed antegrade reamed intramedullary interlocking nails in static versus dynamic mode. METHODOLOGY A prospective comparative cohort study was conducted at Muhammad Teaching Hospital, Peshawar, including 72 patients with femoral shaft fractures (AO 32A2 and 32A3) and (Gustilo-Anderson I, II, IIIA) treated with either static (Group A) or dynamic (Group B) reamed antegrade interlocking intramedullary nails. Patients were followed for 24 weeks postoperatively. The primary outcome was fracture-healing time, assessed using clinical and radiological criteria. RESULTS The mean healing time was significantly shorter in the dynamic group (16.6 ± 4.0 weeks) compared to the static group (19.1 ± 4.4 weeks, p = 0.019). Healing at 24 weeks occurred in 94.4% of the dynamic group, compared with 77.8% in the static group (p = 0.035). Surgery duration was also significantly shorter in the dynamic group (47.3 ± 9.0 minutes vs. 54.9 ± 7.9 minutes, p < 0.001). Subgroup analysis showed faster healing in dynamic nailing for females (p = 0.013), patients ≤40 years (p = 0.010), left-sided fractures (p = 0.049), lower third fractures (p = 0.021), and transverse fracture pattern (p = 0.008).