Results of flexible intra-medullary nailing in paediatric femoral fractures

ABSTRACT

Treatment of fracture femur in children between 6-14 years is still controversial. The aim of this study is to evaluate the results of treatment of fracture femur in children between 6 and 14 years old using elastic stable intramedullary nailing [ESIN]. ESIN was used to treat 20 patients between the age of six and fourteen years old with fracture shaft femur. The main mechanism of trauma was road traffic accidents. One fracture was an open grade II fracture. The most encountered level of the fractures was in the middle third. The mean time lapse before surgery was 6.65 +/- 5.4 days. The final results obtained were excellent in eighteen patients [90%] and good in two patients [10%]. The mean time to clinical union was 5.65 +/- 0.81 weeks, while the mean time to radiological union was 7.55 +/- 1.39 weeks. Final score had no statistically significant relations to age, sex, side affected, time lapse before the operation, minimum canal diameter, nail diameter used, intra-operative image intensifier time, mechanism of trauma, type/level/shape of fractures, the presence of associated injuries, and technique of reduction. Four patients had pain at insertion site, two had 10 external rotation, two had 20 valgus, one had 10 varus deformity and one had 10 anterior angulation. We concluded that flexible intramedullary nailing is an accepted treatment option with the advantage of shorter hospital stay and early recovery