Comparative Study of Core-Drill Intramedullary Nail System and External Targeting System for Femoral Shaft Fractures

Zhu Xingfei; Ma Dang; Jiang Chao; Wang Zhiyuan; Fan Jian

doi:10.3969/j.issn.1008-5572.2025.09.004

Abstract：Objective To compare the clinical efficacy of the core-drill intramedullary nail system(CINS)and the traditional external targeting system(ETS)in interlocking intramedullary nailing for femoral shaft fractures.Methods A retrospective analysis was performed on data of 47 patients with femoral shaft fractures treated at Tongji Hospital of Tongji University,from January 2020 to December 2023.According to the surgical method,patients were assigned to CINS group and ETS group.CINS group contained 22 cases(8 males and 14 females),age 21～77 years,mean(50.4±19.3)years;ETS group contained 25 cases(17 males and 8 females),age 21～79 years,mean(50.8±20.4)years.Surgical-related parameters,fracture healing time,visual analogue scale(VAS)pain score,Harris score and complications were compared between the two groups.Results Post-operative follow-up lasted 11.6～18.3 weeks,mean(14.53±1.76)weeks.Intra-operative fluoroscopy frequency,operative time and peri-operative blood loss in CINS group were significantly better than those in ETS group(P＜0.01).Fracture healing time and post-operative Harris score showed no significant difference between the two groups(P＞0.05);post-operative VAS in CINS group was lower than that in ETS group,the difference being statistically significant(P＜0.01).Complication incidence showed no significant difference between the two groups(P＞0.05).One soft-drill breakage occurred in CINS group,related to high bone density and insufficient early operative experience.Conclusion In interlocking intramedullary nailing for femoral shaft fractures,CINS and traditional ETS provide equivalent clinical efficacy;CINS offers higher distal locking accuracy,less intra-operative radiation exposure and less blood loss,but its use in patients with high bone density requires caution.