Flexible intramedullary nailing in pediatric femoral fractures, short term results at a secondary healthcare system

Abstract

Background: Femoral fractures in children are among the most common fractures of long bones. The definitive treatment modalitiy remains controversial. Flexible intramedullary nailing has emerged as an accepted procedure for femoral fractures in school going children. We thus undertook a prospective study of paediatric femoral fractures treated with flexible titanium nailing at our centre which is a secondary health care. Material and Methods: Our study included 18 patients having femoral fractures treated with retrograde flexible intramedullary nailing. In our study we had males and females with right side and on left side. Patients were followed up for a mean period of 10 months. Results: Patients were followed up till their fractures healed or until the last followup visit. The mean length of follow-up was 10 months. All patients united uneventfully. Radiological union was evident in a mean time of 8.44 weeks ranging from 6 to 12 weeks. Three patients got limb lengthening of 1 – 1.5cm. Two patients got a varus angulation of less than 10o. There was no case of entry site irritation or any nerve palsy. One patient got a peculiar entry site medial localized cortical longitudinal fracture. There were 12 excellent and 6 satisfactory results using outcome criteria of Flynn et al for titanium elastic nail. Conclusion: Flexible nailing in pediatric femoral fractures yields excellent and satisfactory outcome with a relatively free from major complications.