Flexible intramedullary nails: the panacea for paediatric femoral shaft fractures


  • Jagdeep Singh Department of Orthopaedic Surgery, GGSMCH, Faridkot, Punjab, India
  • Jagandeep S. Virk Department of Orthopaedic Surgery, GMCH, Chandigarh, India
  • Anoop Kalia Department of Orthopaedic Surgery, GGSMCH, Faridkot, Punjab, India
  • Naveen Mittal Department of Orthopaedic Surgery, GMCH, Chandigarh, India




Femur, Elastic nails, Reduction, Union


Background: Management of pediatric femoral shaft fractures continues to evolve with time with flexible intramedullary nailing being one of the options to treat a specific age group of children. Grey zone exists concerning the cost effectiveness and appropriate timing of nail removal in treating such fractures. The objective of the study was to evaluate the treatment outcome of fracture shaft of the femur in children in the age group of 5- 12 years with flexible intramedullary nail.

Methods: The study comprised of 30 consecutive cases of acute fractures of the femoral shaft in children of the age group of 5 to 12 years. Only closed fractures of the mid-diaphyseal region of the femur were included while supracondylar, subtrochanteric and pathological fractures were excluded. Flexible intramedullary nails of stainless steel (n=24) or titanium (n=6) were used for fixation of these fractures.

Results: Evaluation of the results was done according to the criteria by Flynn et al. 21(70%) out of 30 patients had an excellent result and remaining 9 (30%) had a satisfactory result. All fractures united with a full range of motion at the hip and knee joint without any major complications.

Conclusions: Intramedullary elastic nailing of simple diaphyseal femur fractures in children is an effective method with negligible complications. Treatment cost can be significantly lowered by using the much cheaper stainless steel flexible nails rather than the more expensive titanium nails.

Author Biographies

Jagdeep Singh, Department of Orthopaedic Surgery, GGSMCH, Faridkot, Punjab, India


Jagandeep S. Virk, Department of Orthopaedic Surgery, GMCH, Chandigarh, India

senior resident, orthopaedics

Anoop Kalia, Department of Orthopaedic Surgery, GGSMCH, Faridkot, Punjab, India


Naveen Mittal, Department of Orthopaedic Surgery, GMCH, Chandigarh, India



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Original Research Articles