Intramedullary Nailing of Femoral Shaft Fractures in Children - Benefits and Risks

Abstract

Pediatric femoral fractures should be treated operatively by using intramedullary techniques whenever possible. Definitive treatment by using flexible rods or antegrade locking nails avoids secondary fracture displacement and allows early ambulant treatment of the child. Disadvantages of antegrade intramedullary nailing procedures in the past were due to approaches passing the piriformis fossa. Recently published data of MRI studies following antegrade nailing through a trochanteric approach have shown neither avascular necrosis nor valgus deformity. By using an 8.5 mm antegrade nail made for insertion via the trochanter tip in 15 fractures we did not have any perioperative complications. We have not seen any avascular necrosis at the time of hardware removal as yet. In the younger patients up to 10-11 years, ESIN is an adequate and safe way to stabilize the fracture, reducing hospitalization time and allowing early weight-bearing. From the age of nine to eleven until the time of skeletal maturity, adolescents may be treated by intramedullary, specially designed nails, using a dorsolateral approach through the greater trochanter.

Femoral shaft fracture - children - pediatric femoral fracture - nail

References

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