J Korean Orthop Assoc.  2008 Dec;43(6):665-671.

Comparison of Flexible Intramedullary Nailing with External Fixation for Treating Pediatric Femoral Shaft Fractures

• Park SS
• Park JB

Abstract

PURPOSE: We wanted to compare the outcome of the flexible intramedullary nailing with that of external fixation for treating pediatric femoral shaft fractures.
MATERIALS AND METHODS
Forty-two cases of pediatric femoral shaft fractures were reviewed of which thirty cases of femoral segments were treated with the flexible intramedullary nailing (the FIN group) and the other 12 cases were treated with the external fixation (the EF group). The average age of the patients was 6.9 years and the mean follow-up was 28.8 months. The clinical outcome and complications were evaluated.
RESULTS
In all cases, the reduction was maintained until complete union. In the FIN group there were 20 excellent, 8 satisfactory and 2 poor results whereas there were 6 excellent, 4 satisfactory and 2 poor results in the EF group. Among the complications that required re-admission, there was one case of refracture and one case of deep infection in FIN group; one case of refracture, one case of pin breakage and three cases of deep infections in the EF group.
CONCLUSION
Flexible intramedullary nailing may result in better clinical results and fewer complications when compared with the external fixation, and so the flexible intramedullary nailing may be the treatment of choice for the treatment of pediatric femoral shaft fractures, except for open fractures or fractures with severe soft tissue injury.

Keyword

Femoral shaft; Pediatric fractures; Flexible intramedullary nailing; External fixation

MeSH Terms

Follow-Up Studies
Fracture Fixation, Intramedullary
Fractures, Open
Humans

Figure

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  Fig. 1 A transverse diaphyseal femoral fracture in a 5-year-old boy (A). Flexible intramedullary nailing was applied (B). After five months, the implant was removed (C).

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  Fig. 2 Fracture of the left femoral diaphysis in an 9-year-old boy (A), and this was treated with external fixation (B). The picture on the right shows the femur after fracture healing and removal of the implant (C).

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