A clinical study on the surgical management of fracture shaft femur in children and adolescents by using Ender’s nail
Keywords:Femoral shaft fractures, Spica casting, Flexible, Intramedullary nails, Ender rod
Background: Femoral shaft fractures account for 1.6% of all pediatric bony injuries. Current treatment options include early spica casting, traction, external fixation, open reduction and internal fixation with plating, flexible intramedullary nails and intramedullary rods. Experience of many clinicians has shown that children with diaphyseal fractures do not always recover with conservative treatment. Ender rod fixation in the paediatric population is simple, effective and minimally invasive. It allows stable fixation, rapid healing and a prompt return of the child to normal activity. The objective of the study was to evaluate the functional outcome of the pediatric femur shaft fractures with Ender’s intramedullary nailing.
Methods: 20 patients aged 5 to 16 years with fracture shaft of the femur treated with retrograde flexible intramedullary nailing at Bapuji hospital attached to JJM Medical College, Davangere in the period from September 2014 to August 2015 were included in the study.
Results: All patients were followed until fracture union occurred. The follow up period ranged from 6 months to 1 year. Results were analysed both clinically and radiologically. 1 case united within 8 weeks,14 cases in 10 weeks and 5 cases in 12 weeks. Out of 20 cases there is limb length discrepancy in 6 cases, infection in 2 cases, nail back out in 2 cases, varus malalignment in 2 cases, valgus malalingment in 3 cases, anterior angulation in 6 cases and rotational malalignment in 2 cases..
Conclusions: Closed intramedullary nailing is an efficient method and does not expose the patient to an undue risk of infection or non-union. There is also no risk of limb length discrepancy and the angulation and rotational malalignment are within the acceptable limits. This safe procedure can be recommended in children with multiple injuries co-existent head injury and in age groups 5 to 16 years.
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