Static versus dynamic intramedullary nailing for femoral and tibial shaft fractures: a double-blind, randomized clinical trial.

BACKGROUND

The optimal fixation method for femur and tibia shaft fractures remains debated. Both static intramedullary nailing (SIMN) and dynamic intramedullary nailing (DIMN) are commonly used. This study aims to compare the efficacy of SIMN versus DIMN in promoting fracture healing.

METHODS

This double-blind, randomized clinical trial was conducted from June 2022 to March 2024. Fifty-two people with single transverse or short oblique femur or tibia fractures were randomly put into two groups, SIMN and DIMN. Each group had 26 people. The primary outcome was time to union, and secondary outcomes included surgical and post-surgical complications. Statistical analysis was performed using SPSS version 28.0.

RESULTS

The study included 52 participants (22 men and 30 women), with a mean age of 54.48 (SD 11.31). The median time to union in the DIMN group was significantly lower than in the SIMN group (20.5 (IQR 17-24) versus 24 (IQR 22-35), P = 0.008). No statistical significance was observed in either group regarding nonunion, malunion, delayed union, and reoperation rates.

CONCLUSION

Dynamic intramedullary nailing (DIMN) significantly reduces the median time to union compared to static intramedullary nailing (SIMN) for femoral and tibial shaft fractures. Despite the shorter union time with DIMN, both techniques showed similar outcomes regarding nonunion, malunion, delayed union, and reoperation rates. These findings suggest that while DIMN may offer faster fracture healing, SIMN and DIMN are viable options depending on individual patient and clinical considerations.