Flexible intramedullary nailing in paediatric femoral fractures. A report of 73 casesReport as inadecuate




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Journal of Orthopaedic Surgery and Research

, 6:64

First Online: 22 December 2011Received: 29 May 2011Accepted: 22 December 2011

Abstract

BackgroundFlexible intramedullary nailing has emerged as an accepted procedure for paediatric femoral fractures. Present indications include all patients with femoral shaft fractures and open physis. Despite its excellent reported results, orthopaedic surgeons remain divided in opinion regarding its usefulness and the best material used for nails. We thus undertook a retrospective study of paediatric femoral fractures treated with titanium or stainless steel flexible nails at our institute with a minimum of 5 years follow up.

Material and methodsWe included 73 femoral shaft fractures in 69 patients treated with retrograde flexible intramedullary nailing with a minimum follow up of 5 years. Final limb length discrepancy and any angular or rotational deformities were determined.

ResultsMean age at final follow up was 15.5 years 10-21 years. Mean follow up was 7.16 years 5.0-8.6 years. Titanium and stainless steel nails were used in 43 and 30 cases respectively. There were 51 midshaft, 17 proximal, and 5 distal fractures.

All fractures united at an average of 11 weeks but asymptomatic malalignment and LLD were seen in 19% and 58% fractures respectively. LLD ranged from -3 cm to 1.5 cm. Other complications included superficial infection2, proximal migration of nail3, irritation at nail insertion site5 and penetration of femoral neck with nail tip1. There were 59 excellent, 10 satisfactory and 4 poor results.

ConclusionFlexible intramedullary nailing is reliable and safe for treating paediatric femoral shaft fractures. It is relatively free of serious complications despite asymptomatic malalignment and LLD in significant percentage of fractures.

Electronic supplementary materialThe online version of this article doi:10.1186-1749-799X-6-64 contains supplementary material, which is available to authorized users.

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Author: Ramprakash Lohiya - Vikas Bachhal - Usman Khan - Deepak Kumar - Vishwapriya Vijayvargiya - Sohan S Sankhala - Rakesh Bharg

Source: https://link.springer.com/







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