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Year : 2018  |  Volume : 53  |  Issue : 1  |  Page : 83-87

Treatment of the femoral shaft fractures in children by a single elastic stable intramedullary nail

Department of Orthopedic Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Amro S El-Sayed
Lecturer of Orthopedic Surgery, Faculty of Medicine, Menoufia University, Menoufia, 32817
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/eoj.eoj_22_18

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Introduction A femoral fracture is the most common major pediatric injury treated by orthopedic surgeons. Although the majority heal without long-term sequelae; the most frequent and expensive complications in the field of orthopedics result from the closed treatment of pediatric femoral fractures. Thus, the occasional unsatisfactory outcome maintains the focus on evolving treatment recommendations. It is a closed surgical procedure that allows early weight bearing and walking. Implantation of flexible nails is performed through very small incisions and does not endanger the physes or the blood supply to the femoral head. It aims at rapid restoration of bone continuity and no joint stiffness, and early rehabilitation. Patients and methods This work is a prospective study of 30 children with femoral shaft fracture who had been admitted to El-Menoufiya University Hospital. All cases that fulfilled the inclusion criteria had been treated by a single elastic stable intramedullary nail (ESIN). Results In a total of 30 patients, there were 20 male and 10 female with mean age 8.4 years (range: 5–14 years). Twenty (66.7%) fractures were on the right side and 10 (33.3%) were on the left side. Seventeen fractures were caused by road traffic accident (RTAs), 12 fractures caused by falling from height, and one case due to falling of heavy object over the femur. Callus was first noted on follow-up radiographs at an average of 4 weeks. Radiological union was achieved in all cases in a mean time of 8.6 weeks (range: 6–12 weeks). According to the scoring criteria for ESINs by Flynn and colleagues, the results were excellent in 26 (87%) patients, successful in three (10%) patients, and poor in one (3%) patient. Conclusion The single elastic stable nailing is an effective treatment option in treating femoral shaft fractures in the 5–15 years age group. Although midshaft transverse fractures are the most amenable for treatment with ESINs, they can be used in any type of fractures.

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