Flexible Nails versus Plate for Fixation of Fracture Shaft Femur in Children from 5-12 Years

Background: Pediatric femoral shaft fractures are the most common fractures requiring hospitalization in children and often require prolonged immobilization or surgery. Various techniques have been used to avoid complications in children. This study aimed to evaluate the early clinical and functional outcome after surgical management of femoral shaft fracture in children between 5 to 12 year either by plate or flexible nails. Patients and methods:This study was carried on 24 patients; 12 patients managed by elastic stabile intramedullary nailing (ESIN) and 12 patients managed by plate. All the patients were subjected to history and physical examination, together with plain X-ray antro-posterior and lateral views of femur from hip to knee. Functional outcome was assessed by using Flynn’s TENS outcome score, applied to both the groups at the end of follow up. Results: Mean age of study group was 9.17 (SD 2.12) ranged from 5 years to 12 years. About 62.5% of cases were males and 37.5% were females. Fractures were 70.8% transverse, 25% oblique, and 4.2% spiral. The mean operation time was 36.88 (SD 7.34) minutes and the mean clinical union was 11.58 (SD 2.28) weeks. Time to metal removal was 7.56 (SD 2.80) months. About 8.3% of patients had major complication, and 12.5% had mild complications. Three-fourth of cases had excellent score. ESIN had better outcomes and fewer complications compared with plate. Conclusion: ESIN is the implant of choice for femoral diaphyseal fractures in children aged from 5-12 years.