[Flexible intramedullary nailing of children]

Various methods are being used in the treatment of femur diaphysial fractures in children aged between 6 to 12 years. Titanium elastic nailing is one of the alternatives. We evaluated our experience in flexible intramedullary nailing.

We investigated 21 patients with femur diaphysial fractures who were with titanium elastic nailing.

The mean age of the patients was 9.6+/-2.4 (range between 5.1-14.7 years) and all the fractures were at the diaphysis. The fracture pattern was as following: 9 (42.9%) transverse, 7 (33.3%) oblique, 5 (23.8%) spiral. Fixations were performed with two nails which were implanted in retrograde manner. The average time of follow-up was 29+/-11.6 months (range; 9-48 month). The mean time to fracture union was 13+/-11.9 weeks (4-52). Implant removal was performed after a mean time of 7+/-2.2 months (range; 6-16 month). Patients's hip and knee range of motions were complete and clinically there were no angular or rotational deformity at postoperative one year. There were radiologically 11+/-1.7 (range; 10-15) degrees of varus valgus malalignment in 8 patients; these angles were reduced to 5+/-1.9 (range; 3-9) degrees at the follow of two years.

The results of the flexible titanium nailing in femur diaphysial fractures of the children, aged between 6 to 12 years, suggest that this method may be a first choice therapy in this particular group of patients.