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Flexible Intramedullary Nail Versus Submuscular Locked Plate with the Cluster Technique in Pediatric Femoral Shaft
Wael El-Adly1, Kamal El-Gafary1, Mohamed Khashaba1
1Orthopedic Surgery Department, Faculty of Medicine, Assiut University Hospital, Assiut University, University Street, Asyut, 71515 Egypt.
Insights
Submuscular locked plates with cluster technique show better outcomes for pediatric femoral shaft fractures than flexible intramedullary nails. This fixation method leads to fewer complications and improved functional results in children aged 6-12 years.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Traumatology
Background:
- Pediatric femoral shaft fractures require effective fixation methods.
- Comparing flexible intramedullary nails and submuscular locked plates is crucial for optimal treatment.
Purpose of the Study:
- To compare flexible intramedullary nailing (IMN) versus submuscular locked plating with cluster technique for pediatric femoral shaft fractures.
- To evaluate outcomes in children aged 6-12 years with simple diaphyseal fractures.
Main Methods:
- Fifty children aged 6-12 years with femoral fractures were randomly assigned to two fixation groups.
- Follow-up was conducted for 1 year, comparing various parameters and outcomes.
Main Results:
- No significant demographic or fracture classification differences between groups.
- Plating group had longer operative/radiation times but less blood loss.
- Plating group demonstrated superior knee range of motion, weight-bearing, alignment, length, and fewer complications.
Conclusions:
- Submuscular locked plating with cluster technique is supported over flexible IMN for the studied pediatric femoral fractures.
- This method offers better functional outcomes and fewer complications in pediatric patients.
Purpose Of The Study:
The aim of this study is the comparison between the flexible intramedullary nail and submuscular Locked Plate with the cluster technique in fixation of pediatric femoral shaft fractures at the age group between 6 and 12 years old with simple diaphyseal closed or Gustilo open grade I fractures.
Methods:
Fifty children aged 6-12 years with femoral fractures were enrolled in this study. The children were randomly assigned equally to the two groups for fractures fixation. The follow-up period was 1 year. A comparison of various parameters and outcomes between both groups was documented.
Results:
No significant differences were detected between both groups regarding the age, gender, affected side, mechanisms of fracture, or fracture classifications. The operative time and radiation time were longer in the plating group, while the amount of blood loss was lesser in the nail group. The patients treated with plating had better results concerning knee range of motion, weight-bearing, malalignment, and length discrepancy, with fewer complications and better functional outcomes.
Conclusion:
The result of the present study supports the use of submuscular locked plate with cluster technique in the treatment of studied fractures over flexible IMN.
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