Abstract
Flexible intramedullary nailing has become a popular method of fixation of femur fractures in children. The purpose of this study was to analyze complications following titanium elastic nailing in pediatric femur fractures. Sixteen consecutive femoral shaft fractures treated with titanium elastic nails in children 5–15 years of age were analyzed for complications. Fracture union occurred at a median 6 weeks. Major complications were present in two patients. Children ≤10 years had higher risk of limb lengthening (P = 0.021). Risk of sagittal plane angulation was higher in children ≥10 years (P = 0.017). Leaving the outer portion of the nail shorter resulted in better knee range of motion and earlier achievement of functional knee motion. There was no incidence of skin irritation due to nails. There were two major and two minor complications. Both major complications occurred in patients with substandard nail/canal and weight/nail ratios. Though titanium elastic nailing is easy to perform and is minimally invasive, strict adherence to the principles of the procedure is mandatory. Understanding the complications and ways to avoid them will help the orthopedic surgeon achieve better results.
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