Abstract:

Objective: This study compared the clinical and radiological outcomes of screw and talon locking systems, which are distal nail locking systems, in adult femoral shaft fractures treated with intramedullary nails. Methods: The data of patients who received intramedullary nails were retrospectively analyzed. The patients were divided into two groups: patients treated with conventional intramedullary nails (group 1) and those with a talon distal locking system (group 2). Both groups were assessed according to age, sex, fracture side, type of implant, length of surgery, fluoroscopy shot number of intraoperative fluoroscopy, length of postoperative follow-up, time to union, smoking, AO classification of fractures, and presence of malunion and nonunion. Additionally, patients were compared using the Knee Society score and Harris Hip score as clinical functional scores. Results: Among 102 study patients, were 21 (20.5%) females and 81 (79.5%) males, with a mean age of 39.34 (18-65) years. When the time to union, fluoroscopy shots number and length of surgery were compared between the groups, the results were statistically significant (p<0.05). There was no statistically significant difference in malunion and nonunion rates between the groups (p>0.05). Results of clinical scores were similar in both groups and there was no statistically significant difference (p>0.05). Additionally, smoking, age, sex and subtype of fracture did not have a statistically significant association with time to union, and malunion and nonunion rates (p>0.05). Conclusion: The talon system is a reliable method that provides an advantage in terms of radiation exposure and length of surgery compared to the conventional locking system. The union time was observed to be longer in patients using the talon system compared with the conventional method, and a joint decision should be made by the surgeon and the patient on the treatment method, by informing the patients about the advantages and disadvantages of this system before the operation.

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