Outcome of Locked Reamed Intramedullary Nail v/s K-NAIL Plus Augmented Plating in Aseptic Distal Femur Non-Union

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Published: Apr 15, 2024
DOI: https://doi.org/10.61919/jhrr.v4i2.753
Keywords:
Aseptic Nonunion, Distal Femur, Locked Reamed Intramedullary Nailing, K-nail Augmented Plating, Bone Union, Orthopedic Surgical Techniques, mRUST Scores, Implant Failure, Intraoperative Blood Loss, Operative Time

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Syed Zain Abbas
DHQ- Gujranwala- Pakistan.
Muhammad Waqas Azam
DHQ- Johrabad- Sarghoda- Pakistan.
Shuja Uddin
Lahore General Hospital Lahore Pakistan.
Abdul Waqas
LGH- Lahore- Pakistan.
Junaid Khan
LGH- Lahore- Pakistan.
Sohaib ilyas
LGH- Lahore- Pakistan.
Muhammad Kahlid Syed
LGH- Lahore- Pakistan.

Abstract

Background: Aseptic nonunion of the distal femur presents a significant challenge in orthopedic surgery, affecting patient outcomes and healthcare systems. Traditional treatments include locked reamed intramedullary nailing (LRIN) and K-nail with augmented plating, with varied reported efficacies.


Objective: The study aimed to compare the outcomes of LRIN versus K-nail plus augmented plating in the treatment of aseptic nonunion of the distal femur, focusing on union rates, operative time, complications, and functional recovery.


Methods: In this prospective comparative study, 50 patients with aseptic nonunion of the distal femur were randomly assigned to undergo either LRIN (Group A) or K-nail plus augmented plating (Group B). The primary outcome measures included the modified Radiographic Union Score for Tibial fractures (mRUST) and rates of implant failure and infection. Secondary outcomes considered operative time and intraoperative blood loss. Statistical analysis was performed using SPSS version 25, with a p-value of less than 0.05 deemed significant.


Results: Group A exhibited higher mRUST scores at 12 weeks (4.84 vs. 4.16, p=0.010), 24 weeks (6.40 vs. 5.48, p<0.001), and 36 weeks (8.12 vs. 7.00, p<0.001). Nonunion rates at 36 weeks were lower in Group A (12% vs. 36%, p=0.047), with no significant differences in infection rates. Operative time was significantly longer for Group A (159.40±5.82 minutes) compared to Group B (123.96±6.20 minutes, p<0.001), but there was no significant difference in blood loss between the groups.


Conclusion: LRIN outperformed K-nail plus augmented plating in promoting bone union in aseptic nonunion of the distal femur, with a lower nonunion rate and higher mRUST scores, despite a longer operative time.

Article Details

How to Cite
Abbas, S. Z., Azam, M. W., Uddin, S., Waqas, A., Khan, J., ilyas, S., & Syed, M. K. (2024). Outcome of Locked Reamed Intramedullary Nail v/s K-NAIL Plus Augmented Plating in Aseptic Distal Femur Non-Union. Journal of Health and Rehabilitation Research, 4(2), 94–99. https://doi.org/10.61919/jhrr.v4i2.753
Issue
Vol. 4 No. 2 (2024): Volume 4, Issue 2 - April to June 2024
Section
Articles
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This work is licensed under a Creative Commons Attribution 4.0 International License.

Author Biographies

Syed Zain Abbas, DHQ- Gujranwala- Pakistan.

Consultant Orthopedic, DHQ- Gujranwala- Pakistan.

Muhammad Waqas Azam, DHQ- Johrabad- Sarghoda- Pakistan.

Consultant Orthopedic, DHQ- Johrabad- Sarghoda- Pakistan.

Shuja Uddin, Lahore General Hospital Lahore Pakistan.

Consultant Orthopedic, Lahore General Hospital, Lahore, Pakistan.

Abdul Waqas, LGH- Lahore- Pakistan.

Registrar, Orthopedic Unit 1, LGH- Lahore- Pakistan.

Junaid Khan, LGH- Lahore- Pakistan.

PG, Orthopedic Surgery, LGH- Lahore- Pakistan.

Sohaib ilyas, LGH- Lahore- Pakistan.

PG, Orthopedic Surgery, LGH- Lahore- Pakistan.

Muhammad Kahlid Syed, LGH- Lahore- Pakistan.

Professor of Orthopedic Surgery, LGH- Lahore- Pakistan.

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