Article

Comparison of compression plate and flexible intramedullary nail fixation in pediatric femoral shaft fractures.

Department of Orthopaedics and Traumatology, Faculty of Medicine, Hacettepe University, Sihhiye, Ankara, Turkey.
Journal of Pediatric Orthopaedics B (impact factor: 0.47). 06/2006; 15(3):210-4. DOI:10.1097/01.bpb.0000186642.91944.68
Source: PubMed

ABSTRACT The purpose of this study was to compare the results of compression plating and flexible intramedullary nailing for pediatric femoral shaft fractures. Thirty-eight consecutive patients with 40 femoral shaft fractures were evaluated. Twenty-two femoral segments were treated with a compression plate and 18 femoral segments were treated with flexible intramedullary nailing. The time to healing, operation time and complications were evaluated. The average operation time was statistically significantly shorter in the nailing group (P=0.039). Four implant failures occurred in the compression plate group whereas one non-union was observed in the flexible nailing group. Flexible intramedullary nailing seems to provide a high union rate with a shorter operation time when compared with plate fixation.

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    Ayman Hussain Jawadi, Adham Abdul-Samad
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    D E Deakin, H Winter, P Jain, C E Bache
    [show abstract] [hide abstract]
    ABSTRACT: Flexible intramedullary nails (FIN) are increasingly used in the management of paediatric tibial and femoral fractures. Concerns have recently been raised regarding the use of FIN in older children. The aim of this study was to determine how effective FIN is in treating tibial and femoral fractures in adolescents. Patients aged 11 years or older undergoing FIN for tibial and femoral fractures between 2003 and 2009 were identified. Radiographs and case notes were reviewed to identify complications. Thirty-five consecutive adolescent patients underwent FIN for tibial (n = 21) and femoral fractures (n = 15), with a mean age of 12.9 years. The mean radiographic follow up was 29 weeks. Sixty percent (60%, n = 9) and 38% (n = 9) of femoral and tibial fractures, respectively, malunited. Fracture severity was associated with increased malunion for both tibial and femoral fractures (P = 0.046 and P = 0.044, respectively). Two femoral fractures took longer than 20 weeks to unite and seven tibial fractures took longer than 16 weeks to unite. The higher than expected rates of malunion and delayed union in this study suggest that other treatments should be considered when treating adolescents with unstable tibial or femoral fractures.
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Keywords

18 femoral segments
 
40 femoral shaft fractures
 
average operation time
 
compression plate
 
compression plate group
 
compression plating
 
consecutive patients
 
femoral segments
 
Flexible intramedullary nailing
 
flexible nailing group
 
nailing group
 
non-union
 
operation time
 
pediatric femoral shaft fractures
 
shorter operation time
 
union rate