Outcomes of fracture shaft femur in pediatric population managed at emergency

J Clin Orthop Trauma. 2017 Oct-Dec;8(4):313-319. doi: 10.1016/j.jcot.2016.12.004. Epub 2016 Dec 15.

Abstract

Background: Fracture shaft of femur is amongst one of the commonest major diaphyseal injuries in school going children presenting to us at emergency rooms of our hospitals. The presence of a growing proximal and distal physes imposes a real challenge in management of these fractures. The use of titanium elastic nails has gained wide acceptance for stabilizing these fractures.

Materials and methods: A sample of 53 children of age group 6 to 12 years were included in the study according to the inclusion and exclusion criteria. The mean age of subjects was 8.87 ± 1.64 years of which 39 were males and 14 were females. The femoral shaft fractures were stabilized using titanium elastic nails and followed up for a mean duration of six months. The outcomes were evaluated based on Flynn's criteria.

Results: We obtained excellent outcome in 75.5% of our cases, satisfactory outcome in 17% and poor outcome in 7.5% of cases. We found no statistically significant difference in outcome in patients of age 9 years or less compared to 10 years or older.

Conclusion: Patient selection is important to obtain good results using titanium elastic nails. Mid diaphyseal femoral shaft fractures with minimal comminution are ideal fractures for treatment using titanium elastic nails.

Keywords: Femur; Intramedullary; Pediatric; School-age; Trauma.