Role of Elastic Intramedullary Nail for the Treatment of Femur Shaft Fractures in Children

Syed Kamran Ali Shah, Asif Peracha, Muhammad Arsalan Ghazi, Nouman Memon, Kazim Rahim Najjad, Sajid Younus

Abstract

Objective: To demonstrate the effectiveness of intramedullary fixation of femur shaft fracture in children using elastic intramedullary nails. Method: This prospective observational study was performed from January 2014 to December2016. 26 patients admitted with femur diaphyseal fractures with mean age from 6 to 12 years, who subsequently underwent femur elastic intramadullary nail insertion in retrograde fashion for the treatment of femoral shaft fractures were enrolled in the study. Patients were in regular follow up till radiological union achieved. Flynn scoring criteria is used to assess the functional outcomes at 6 months follow up. 
Results: The Mean age of patient in our study was 9 years (6- 12 years), all 26 patients were in regular follow up for average 26 weeks (14-36 weeks). Radiological union achieved in all patients in a mean time of 9 weeks (range 6-12 weeks). Two patients had skin breakdown at entry site, which lead to superficial infection. One patient had limb length discrepancy upto1.5cm and one patient had varus angulations up to (10º) and in one proximal migration of nail. According to Flynn Criteria outcome was excellent in 19 patients (73.1%), satisfactory in 6 patients (23.1%), poor in 1 patient (3.8%) respectively 
Conclusion: The use of elastic intramedullary nail in femoral diaphyseal fracture is better option in pediatric age group as it gives satisfactory outcome with minimum complication rates because of simple operating technique with less operating time and satisfactory radiological union achieved to accomplish the goal of treatment. So it could be considered as a favorable treatment option for femoral shaft fracture in pediatric age group.