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01-07-2012 | Original Clinical Article

Intramedullary nails for pediatric diaphyseal femur fractures in older, heavier children: early results

Authors: Richard A. K. Reynolds, Julie E. Legakis, Ronald Thomas, Theddy F. Slongo, James B. Hunter, Jean-Michel Clavert

Published in: Journal of Children's Orthopaedics | Issue 3/2012

Abstract

Purpose

A common treatment for pediatric femur fractures is intramedullary nail (IMN) insertion. Elastic stable intramedullary nails (ESINs) are often used for these procedures in heavier patients, but the potential for complications and malunion is greater. We describe here a rigid IMN specifically designed for adolescents, the adolescent lateral entry femoral nail (ALFN). The purpose of this study was to compare the recovery and complications for patients treated with ESINs to those treated with the ALFN.

Methods

Our study design was a retrospective cohort study. We performed a review of medical records of 22 children ages 10–17 requiring surgical fixation of a femur fracture for a 2½-year period. Patients selected for the study had traumatic diaphyseal femur fractures and were treated with ESINs without end-caps or ALFNs. Our analyses evaluated injury, surgical, and outcome information for all patients.

Results

Twenty-two patients were eligible for inclusion and were divided into two groups according to their treatment: the ESIN group with 7 patients and the ALFN group with 15 patients. We then performed a comparison of complications and recovery for these patients. The mean time to full weight-bearing was significantly less for the ALFN group (4.1 weeks; SD, 2.2), than the ESIN group (9.4 weeks; SD 3.9). There was no statistical difference in the incidence of major or minor complications.

Conclusions

Older, heavier pediatric patients treated for femur fracture with ALFNs had a shorter recovery time than similar patients treated with ESINs. However, the outcomes for both groups were satisfactory.

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Title: Intramedullary nails for pediatric diaphyseal femur fractures in older, heavier children: early results
Authors: Richard A. K. Reynolds
Julie E. Legakis
Ronald Thomas
Theddy F. Slongo
James B. Hunter
Jean-Michel Clavert
Publication date: 01-07-2012
Publisher: Springer Berlin Heidelberg
Published in: Journal of Children's Orthopaedics / Issue 3/2012
Print ISSN: 1863-2521
Electronic ISSN: 1863-2548
DOI: https://doi.org/10.1007/s11832-012-0404-4

At a glance: The STEP trials

Springer Medicine

Intramedullary nails for pediatric diaphyseal femur fractures in older, heavier children: early results

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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