Elastic Stable Intramedullary Nailing Femoral Shaft Fractures in Children from Six to Ten Years Age

Abstract

Background: Diaphyseal fractures of the femur (DFF) are common long-bone injuries in children and adolescents. DFF represent 1.5% of fractures in childhood.Objective: This study aimed to evaluate the clinical, functional and radiological outcome of femoral shaft fractures, which are managed by elastic stable intramedullary nailing (ESIN) in pediatric age 6-10 years. Patients and Methods: A prospective clinical randomized trial study was conducted on18 children underwent elastic stable intramedullary nailing (ESIN) for treating femoral shaft fractures at Orthopedic department, Zagazig University Hospitals during the period from April to December 2020. Plain X-rays of the femur Antero-posterior (AP) & Lateral (Lat.) views (from hip to the knee joint) was taken. Results: The time to surgery was 1.39 ± 1.12 days ranging from 1 to 6 days, the time till full union was 9.4 ± 1.76 weeks ranging from 7 to 12 weeks, more than half of the studied group (55.5%) ranged from 7 to 9 weeks and the time of full weight bearing was 9.6 ± 1.7 weeks ranging from 7 to 12 weeks, half of the studied group (50.0%) ranged from 7 to 9 weeks. So, the final outcome was 83.3% had excellent functional outcome, 11.1% of them had satisfactory functional outcome and 5.6% had poor functional outcome. 88.8% didn't have any complications, 5.6% of them had irritation and 5.6% had superficial infection. Conclusion: ESIN is the choice treatment for transverse and short oblique shaft fractures in patients aging from 6 to 10 years old.

Early complications of elastic stable intramedullary nails in the treatment of pediatric diaphyseal fractures of long bones: an experience in Duhok center of Orthopedic Surgery

“…Regarding union, we found that delayed union happened in 2 out of 43 patients (4.65%), and loss of reduction in 3 patients (7%), this is a higher rate compared to a study done by Fernandez et al where they found that delayed union happened in fourteen 14 out of 553 patients (2.53%) and secondary loss of correction happened in 6 out of 553 patients (1.08%) of forearm fractures, this was attributed comminution and spiral fracture patterns, however, both studies the patients were not functionally disabled and malunion was within the clinically acceptable range, while the delayed union was dealt with by follow-up with no surgical intervention 10 . Thirty-nine patients with femur fractures out of 100 patients have taken part in this study, with a mean age of 6.21+/-2.64 years.…”