Femur Fracture in Preschool Children: Experience with Flexible Intramedullary Nailing in 72 children

• Published in: Journal of pediatric orthopaedics Vol. 27; no. 3; pp. 299 - 303
• Main Authors: Bopst, Lea, Reinberg, Olivier, Lutz, Nicolas
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-04-2007; Lippincott
• Subjects: Biological and medical sciences; Bone Nails; Child, Preschool; Female; Femoral Fractures - diagnostic imaging; Femoral Fractures - surgery; Fracture Fixation, Intramedullary - methods; Humans; Infant; Injuries of the limb. Injuries of the spine; Length of Stay - statistics & numerical data; Male; Medical sciences; Orthopedic surgery; Radiography; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Traumas. Diseases due to physical agents; Treatment Outcome; Weight-Bearing; Human; Pediatrics; Femur; Diseases of the osteoarticular system; Intramedullary nailing; Fracture; Trauma; preschool children; Orthopedic surgery; Flexible; Treatment; pediatric trauma; Child; femur fracture; flexible intramedullary nailing
• ISSN: 0271-6798; 1539-2570
• DOI: 10.1097/BPO.0b013e3180326713

Spica cast immobilization is the preferred treatment for closed femur fracture in preschool children. Flexible intramedullary nailing (FIN) is an alternative treatment but has never been specifically evaluated in this age group. A retrospective analysis of 72 children (mean age, 4.1 years; age range, 1.5-5.9 years) with 73 femur fractures treated by means of FIN was performed. The mean length of stay in hospital was 9.1 days (range, 1-46); weight bearing was started at a mean of 16.4 days (range, 1-60 days) after surgery. Follow-up was available in 62 children (mean, 36.7 months; range, 4-124 months). Complications included early distal nail exteriorization in 9 children (12.3%) during the first 10 years of the study. More than 1 cm of femur overgrowth was noted in 6 children (8.2%). Preschool children with femur fracture treated by means of FIN benefited from short hospital stay, early mobilization and weight bearing. Technique-related complications could be avoided. Long-term follow-up is mandatory in these children.