Cary Fletcher

Cary Fletcher

St. Ann’s Bay Hospital, Jamaica

Title: Open locked nailing using an expandable nail: An alternative approach


Cary Fletcher completed his MBBS degree at University of the West Indies in 2001 and went on to complete his Doctorate in Orthopaedics in 2012, also at The University of the West Indies at the age of 37 years. He is now an Orthopaedic surgeon at St. Ann’s Bay Regional Hospital where he functions as the academic coordinator of the Orthopaedic service. As coordinator, he functions to moderate presentations at all levels of medical staff including residents, interns and student nurses and hence ensure continuing up to date medical education. Doctor Fletcher serves as one of the senior surgeons on the service in which the majority of cases involve Orthopaedic trauma. He is first author on two publications, fifth author on a third and first author on a case report which has been accepted for publication.


Objective: The main objective is to evaluate various outcomes of open intramedullary nailing using the Fixion expanding nail at our institution. Method: A retrospective study was performed using the hospital records. The mechanism of injury, the time between injury and surgery, blood transfusion requirements, blood loss, surgical times, time taken to weight bear (for the femoral/tibial fractures), time for commencement of upper limb use (for humeral fractures), complication rates and the average follow up times were documented. Fifty-seven Long bone fractures in 57 patients were included in this study. Complete results including preoperative X-Rays were available for 27 patients. In 30 cases, the actual X-Rays were not located but documentation by the treating surgeons was available. Results: There were 44 acute femoral fractures, 6 acute tibial fractures, 3 acute humeral fractures, 2 humeral nonunion, 1 tibial nonunion and 1 pathological femoral fracture. All patients achieved radiological union and the complication rates were deemed acceptable. Conclusion: Open intramedullary nailing using an expanding nail may be used for a variety of indications involving the humerus, tibia and femur.

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