Comparison of SIGN interlocking nailing and compression plating in the treatment of aseptic non-union of femoral shaft fractures

Abstract

Background: Aseptic non-union of the shaft of femur presents a treatment challenge with the need for prolonged hospitalization, multiple procedures and economic burden. The choice of treatment is influenced by facilities available in a specified centre. Aim: To compare the results of SIGN interlocking nailing and compression plating in the treatment of aseptic non-union of femoral shaft fractures. Methods: Prospective cohort study conducted over a period of thirty-one (31) months (August 2015 to March 2018). Patients with aseptic non-union of femoral shaft fractures who presented to orthopaedic units of University of Port Harcourt Teaching Hospital, Port Harcourt over the study period were recruited into the study. They were randomly grouped into two—A and B. Group A had open reduction and internal fixation with SIGN interlocking nail, while group B had their fractures fixed by compressive plate osteosynthesis. The patients were followed up for at least six months and the results compared. Results: Forty out of 42 patients completed the study. The SIGN interlocking nailing group had a union rate of 80% (n=16) in six months, while the compression plating group had 95% (n=19). The observed difference was not statistically significant (p=0.342). The two groups also had statistically comparable intra-operative blood loss, wound infection rates, duration for wound healing, post-operative limb shortening and duration of post-operative hospital stay. Conclusion: SIGN interlocking nailing and compression plating are effective methods of treatment of aseptic non-union of femoral shaft fractures. They are comparable with respect to variables evaluated in this study.