Titanium elastic intramedullary nailing for femoral long spiral fractures in children

Abstract

Objective To report titanium elastic intramedullary nailing (TEIN) for femoral long spiral fractures in children.Methods From August 2010 to June 2012,18 children with femoral long spiral fracture were treated in our department.They were 13 boys and 5 girls,aged from 2 years and 2 months to 6 years (average,3.5 years).Fractures were reduced closely and fixated with retrograde TEIN under C-arm fluoroscopy.Functional rehabilitation with cast was enforced for another 2 to 4 weeks after external fixation with plaster or brace for 4 weeks.Results The 18 cases were followed up for an average of 13 months (from 9 to 20 months).Their fractures healed after 3 to 5 months (average,3.5 months).According to the evaluation criteria proposed by Flynn for TEIN of femoral fractures,17 cases were rated as excellent and one as fine at the last follow-up.Five cases reported nail site irritation which was relieved after removal of the nails.One patient showed a longer length (1.1 cm) of the affected leg compared with the normal one.No infection,delayed union,nonunion,broken nail,or injury to the femoral or tibial epiphysis was reported.Conclusion Treatment of the femoral long spiral fractures in children with TEIN is effective and reliable,because of minimal invasion,no interference with the epiphysis,quick functional recovery and limited complications. Key words: Femoral fractures; Fracture fixation, intramedullary; Bone nails; Surgery,minimally invasive; Child