Femoral shaft fractures treated with stainless steel flexible nails in children aged between 5 and 12 years at the HUSVP: A two-year follow-up

Abstract

Purpose The purpose of this study is to show our experience with stainless steel flexible nails in the treatment of femoral shaft fractures in children aged between 5 and 12 years and to observe if the type of material used for nails affects the results. Materials A prospective, descriptive study of a series of cases was performed to evaluate patients treated at the Hospital Universitario San Vicente de Pau´l (HUSVP) who had been followed up for at least 24 months. Results The study group was composed of 48 patients, with an average age of 8.6 years. According to the AO classification, the most common type of fracture was 32A3.2 (61%). The average follow-up period was 43 months. The alterations observed were six cases of clinical length discrepancy, two cases of overgrowing, four cases of shortening, and two malunions in valgus. These alterations had no repercussion in the children's function.The follow-up is the main strength of this study, as it demonstrated that, 2 years after surgery. Conclusion The results with stainless steel nails are as good as those with titanium nails with a shorter follow-up as reported in the literature. Given the high costs of osteosynthesis material in our country, the results of this study provide a less expensive alternative. Level of evidence IV, case series.

Treatment of pediatric femoral shaft fractures by stainless steel and titanium elastic nail system: A randomized comparative trial

“…This difference may be due to the reason that their study was not randomized. However, similar results between two implants were seen in the study by Rios et al, 12 consistent with our study.…”

An Observational Cohort Study of the Adoption of Elastic Stable Intramedullary Nailing for the Treatment of Pediatric Femur Fractures in Kumasi, Ghana

“…In a prospective study, Rios et al published equivalent successful results comparing elastic titanium nails to locally manufactured flexible nails made of steel in the treatment of pediatric femur fractures in a trauma center in Colombia [39]. Alternative less costly implants may be considered for study in LMICs.…”

Flexible intramedullary nails: the panacea for paediatric femoral shaft fractures

“…24 Few studies indicated that the cheaper stainless steel elastic nails are clinically superior to titanium nails for pediatric femoral fixation primarily because of a much lower rate of malunion 25 and provide good, cheap alternative to these expensive nails. 26 A more careful insertion technique is all that is required in stainless steel nails as compared to the titanium nails due to the inadvertent danger of perforating the second cortex with these much stiffer implants.…”