ĐÁNH GIÁ KẾT QUẢ PHẪU THUẬT KẾT XƯƠNG BẰNG ĐINH NỘI TỦY SIGN ĐIỀU TRỊ GÃY KÍN 1/3 DƯỚI XƯƠNG ĐÙI TẠI BỆNH VIỆN QUÂN Y 103

Abstract

Objective: To evaluate the clinical outcomes of internal fixation using SIGN intramedullary nails in the treatment of closed fractures of the distal third of the femoral shaft at Military Hospital 103. Subjects and Methods: A descriptive analytical study was conducted on 36 patients with closed fractures of the distal third of the femoral shaft who underwent internal fixation using SIGN intramedullary nails at Military Hospital 103 between January 2020 and May 2025. Both retrospective and prospective data were collected. Evaluation parameters included fracture characteristics, surgical techniques, postoperative alignment, radiographic union, functional outcomes assessed by the Ter–Schiphort criteria, and complications. Results: Male patients accounted for 58.33%, with 41.67% aged over 60 years. Traffic accidents were the leading cause of injury (66.67%). Simple fracture types according to the AO classification comprised 75% of cases, with A2 fractures accounting for 52.78%. The rate of anatomical reduction was 88.89%. At a minimum follow-up of 12 months, radiographic union in correct alignment was observed in 86.21% of patients, with no cases of nonunion or limb shortening. Mild quadriceps muscle atrophy was present in 6.9% of cases. Functional outcomes were rated as very good in 86.21% and good in 13.79% of patients. A statistically significant association was found between functional outcomes and AO fracture classification (p = 0.038). Conclusion: Closed fractures of the distal third of the femoral shaft are challenging to treat due to complex anatomical characteristics. Internal fixation using SIGN intramedullary nails demonstrated effective fracture reduction and bone healing, with a low complication rate and favorable functional outcomes.