PURPOSE To compare clinical outcomes and complications between pediatric patients with femoral shaft fracture who had undergone conservative treatment and retrograde flexible intramedullary nailing. MATERIALS AND METHODS 51 cases of 46 pediatric patients who had femoral shaft fracture were retrospectively studied. Hip spica cast was applied 3~6 weeks after traction in 24 cases of conservative treatment group and closed reduction and internal fixation with flexible nails were performed in 27 cases. RESULT Neither pain, limitation of joint motion, nor nonunion was reported in both groups. In radiologic evaluation, 4 cases of angulation more than 10 degrees were observed in conservative treatment group and none of surgical treatment group. In leg length discrepancy(LLD) over 10 mm, there was none in surgical treatment group, but 4 cases were seen in the conservative group. Two cases of limping were observed only in the conservative group. Mean time to weight bearing was earlier in surgical treatment group(7.5 weeks) than that in the conservative group(10.8 weeks). CONCLUSION As treatment of pediatric femoral shaft fracture, retrograde flexible intramedullary nailing had less complications such as LLD and angulation and enabled earlier rehabilitation than conservative treatment.
PURPOSE : The purpose of this study is to evaluate the seg length discrepancy after Ender nail fixation in children's femoral shaft fracture. MATERIALS AND METHODS : We reviewed 18 femoral shaft fracture that were treated with Ender nail and studied the relationship between the initial site of fracture, type of fracture and overgrowth. The age of children in this study ranged 6 to 13 years old and the average period of follow-up was 32 months. RESULTS : The range of leg length discrepancy was from 6 mm shortening to 16mm lengthening and average 3.4 mm lengthening. Only one patient had shortening, nine patients had limbs of equal length(less than 2 mm) and eight patients had lengthening.
The average overgrowth was 1.3 mm in proximal 1/3, 7.0 mm in middle 1/3, 3.0 mm in distal 3/1 fractures. The average overgrowth was 7.3 mm in transverse, 1.3 mm in oblique and 2.3 mm in comminuted fractures. Conclusions : We consider closed Ender nailing in children femoral shaft fractures as a good treatment modality in the matter of leg length discrepancy.