Flexible Intramedullary Nail Fixation in Paediatric Femoral Shaft Fractures

BACKGROUND: The objective of this prospective study is to assess the outcome of isolated closed fracture shaft femur, treated with flexible intra-medullary nailing technique in a cohort of 20 children. METHODS: The children with age ranging from 5-15 years with isolated closed fracture shaft femur were included in the study. All the patients were treated with flexible intra-medullary nails using a standard surgical technique. Postoperatively, the patients were mobilized non weight bearing. Patients were followed up at regular intervals and assessed for union clinically and radiographically. Once the signs of union were present, they were weaned off crutches gradually. Limb length, rotational alignment and recurvatum of knee were assessed clinically. RESULTS: The mean age of the children was 8.9 (5.2 – 13.1) yrs. All fractures attained union. The average time of follow-up was 23.6 (19-27) months. Recurvatum deformity of the knee was not seen in any of the patients. Five patients had limb length discrepancy ranging from -5 mm to +8 mm, but none of them needed any treatment for this problem. Four patients developed average 5.5 (5-7) degree of external rotation deformity which was well tolerated. CONCLUSION: We conclude that flexible intramedullary nail fixation of fracture shaft femur in children aged 5-15 years is a very acceptable way of treatment and is associated with minimal complications if the surgeon sticks to the proper way of applying this technique.