Comparison of Closed Versus Open Interlocking Nail Femur: A Retrospective Cohort Study in a Tertiary Care Hospital


  • Shaikh Naeem-Ul-Haq Assistant Professor, Department of Orthopedic Dow international Medical College/Dow University of Health Sciences Karachi, Sindh-Pakistan
  • Syed Abdur Rub Abidi Assistant Professor, Department of Orthopedic Jinnah Medical & Dental College/JMCH Karachi
  • Syed Amir Jalil Professor, Department of Orthopedic Karachi Medical & Dental Council, Karachi
  • Syed Adnan Ahmed Consultant Orthopedic Surgeon AO Clinic Karachi
  • Zamir Hussain Tunio 5Assistant professor Department of Orthopedic Surgery and Traumatology, Liaquat University of Medical and Health Sciences, Jasmshoro
  • Muhammad Farooq Umer Professor, Department of Surgery Jinnah Medical & Dental College Karachi
  • Taha Junaid Khan Assistant Professor, Department of Orthopedic Jinnah Medical & Dental College/JMCH Karachi


Femur shaft, interlocking nail, delayed union, union, non union, infection.


Objective: To compare the results of closed interlocking nail shaft of femur versus open interlocking nail in terms of union, non-union and infection rate.

Methods: We conducted this retrospective Cohort study in Department of Orthopedics Jinnah Medical College Hospital Karachi and Dow University Hospital- Ojha Campus Karachi. The medical record of all patients meeting the inclusion criteria and operated for interlocking nails(closed/open) shaft of femur in the time period extending from 23rd February 2018 to 3rd March 2019 were included in our study. The demographic details, radiographs, operative notes and follow up records of both groups were noted. The post-operative results of union, non-union and infection at final evaluation at one year were compared in both groups. Chi square test was applied and P value calculated. P value < 0.05 was considered significant.

Results: The medical record of 116 patients with mean age 31.1±8 were examined. Closed interlocking nail (group A) was done in 62 patients with mean age 31.1±7.9 years(range 20 to 55 years) while fracture site was opened(group B) in 54 patients with mean age 31.2±8.2years(range 19 to 57 years. The average time of radiological union was 20.5 ±3 weeks in closed versus  26.3±6 weeks in open nailing(  P value <0.05).The rate of union in group A was 95.1%(n=59) and 77.7%(n=42) in group B.(P <0.05) Delayed union was documented in 6(9.6%) patients in group A and 14(25.9%) in group B(P<0.05).Non-union was noted in 03(4.8%) patients in group A and 12(22.2%) patients in group B. Superficial infection was noted in   4(6.4%) in group A and 13(24%) patients in group B.(P <0.05)

Conclusion: Closed interlocking nail for fracture shaft of femur resulted in earlier union, better union rates and less infection rate than open interlocking nail. Every effort must be made to avoid opening fracture side in interlocking nail femur.


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How to Cite

Shaikh Naeem-Ul-Haq, Syed Abdur Rub Abidi, Syed Amir Jalil, Syed Adnan Ahmed, Zamir Hussain Tunio, Muhammad Farooq Umer, & Taha Junaid Khan. (2020). Comparison of Closed Versus Open Interlocking Nail Femur: A Retrospective Cohort Study in a Tertiary Care Hospital. Journal of Pakistan Orthopaedic Association, 32(03), 125–130. Retrieved from

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