A prospective study of management of pediatric femoral diaphyseal fractures using intramedullary titanium elastic nails

Author : Ramachandra K, Virupaksha Reddy S P, Abipray Gahlowt, Akshay S D, Veerabhadra Javali, Remya, Sreekantha

Background and Objective: Femoral shaft fractures account for 1.6% of all Pediatric bony injuries. Angulation, malrotation and shortening are not always corrected effectively. Fixation of femur fractures in children and adolescents by elastic stable intramedullary nailing is becoming widely accepted because of the lower chance of iatrogenic infection and prohibitive cost of in-hospital traction and spica cast care. The objective of the study was to study the functional outcome, duration of union and the complications following the use of elastic nail for femoral shaft fractures in children & adolescents. Method: Children and adolescents between the age group of 5-16 years with Femoral shaft fractures were admitted to Navodaya Medical College and Research, Raichur from August 2011 to August 2012. All patients underwent elastic stable intramedullary nailing fixation for the sustained fracture. Patients were followed up from 3 weeks to 6 months after surgery. A minimum of 30 cases were studied without any sampling procedure. Result: The study comprised 19 male patients and 11 female patients aged from 5 to 16years with mean of 10.5 years. The commonest duration from date of injury to date of surgery was 2 to 4 days. The follow-up ranged from 3 weeks to 6 months. Interpretation and Conclusion: Elastic stable intramedullary nail leads to rapid fracture union by preservation of fracture hematoma and limited soft tissue exposure. It also helps in preventing damage to the distal femoral physis. Hence we conclude that flexible intramedullary nailing is an excellent technique for the treatment of diaphyseal fractures of the femur in children and adolescents aged 5 to 16 years.

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