Dual Fixation in Complex Long Bone Fractures: A Case Series of 30 Patients

Area of Science:

• Orthopedic surgery
• Traumatology
• Biomechanical engineering

Background:

• Complex long bone fractures present fixation challenges, with intramedullary nailing sometimes leading to mechanical failure, delayed union, or non-union.
• Dual fixation strategies are explored to enhance biomechanical stability and improve healing outcomes in these complex cases.

Purpose of the Study:

• To evaluate the clinical and radiological outcomes of primary dual fixation in complex long bone fractures.
• To assess the role of dual fixation as a proactive strategy against fixation failure and non-union.

Main Methods:

• A prospective case series of 30 adult patients with complex long bone fractures (femur, humerus, ulna) treated with dual fixation (intramedullary nail + plate augmentation).
• Follow-up for at least 12 months, assessing radiological union, functional scores (DASH, LEFS), mobilization time, and complications.

Main Results:

• 100% radiological union achieved, with a mean time of 16.5 weeks; 10% experienced delayed union resolving without intervention.
• No cases of non-union or construct failure were observed.
• Excellent-to-good functional outcomes in 86.7% of patients, with low complication rates (superficial infection, implant irritation).

Conclusions:

• Primary dual fixation is a reliable strategy for complex long bone fractures, yielding high union rates and excellent functional results.
• This combined approach mitigates risks of delayed union, non-union, and fixation failure associated with single fixation methods.
• Dual fixation warrants consideration as a primary treatment option for selected complex fractures, meriting further comparative study.