Vol. 10, Issue 4 (2024)

Femoral shaft fractures are highly prevalent. Surgical treatment isthe optimal approach for managing them as it greatly decreases the rates of illness and death in injured people. The optimal therapy for these diseases entails the utilization of nail, plates, screws, and external fixation devices. Currently, reamed intramedullary nailing is regarded as the optimal approach and universally recognized treatment indicated for fractures occurring in the shaft of the femur. 
Experimental procedures and techniques: The study done at Krishna Hospital in Karad between February 2022 and July 2024 included thirty adult Individuals suffering from comminuted fractures of the femoral shaft. The group consisted of 25 males and 5 females. The age range of the participants was between 20 and 45 years. 
Outcome: All 30 patients successfully obtained fracture union. The assessment of Fracture healing was conducted by evaluating the formation of callus in the postoperative X-rays (figures 3, 4, and 5). Our analysis revealed no significant disparity in limb length. There were no instances of postoperative wound infection observed in any of the patients. No cases of plate avulsion or loosening were reported in this investigation.
No patient experienced any postoperative knee or hip discomfort after undergoing combination fixation using a femur nail with derotation plate.
Discussion: By integrating femur nailing with plate augmentation, we can achieve the benefits of both methods for fixing fractures while minimizing their possible issues and downsides. The femur nail functions as a load sharing device, counteracting the shear stresses at the fracture site and Ensuring the consistent positioning of the fracture. Derotation plate fixation is used to manage excessive movement at the fracture site, ensuring stability and preventing any reduction loss.
Conclusion: A composite implant design, consisting of a combination of nailing and derotation plate, is a practical and rational choice for stabilizing Fractures of the femoral diaphysis. It can be considered as a viable substitute for interlocking nail fixation. Compared to the utilization of either conventional plating and screws or a solitary nail, this procedure offers a more reliable and steady fixing, hence decreasing the likelihood of reduction loss. Moreover, this approach encounters less issues. The attained stiffness is crucial for allowing prompt weight bearing and helping the recovery of patients with complex fractures.