Journal of Musculoskeletal Trauma

Original Articles

Treatment of femoral diaphyseal fractures in children: Comparison between conservative treatment and retrograde flexible intramedullary nailing: Chang Wug Oh, Byung Chul Park, Joo Chul Ihn, Hyung Tae Soh, Seung Hoon Baek; J Korean Soc Fract 2002;15(2):292-298. Published online April 30, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.2.292

Abstract PDF: 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.

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Retrograde Flexible Intramedullary Nailing of Pediatric Femur Fractures: Chang Wug Oh, Byung Chul Park, Hyung Jin Park; J Korean Soc Fract 2001;14(2):272-277. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.272

PURPOSE
This study was designed to evaluate the clinical effectiveness including bone union, leg length discrepancy, after retrograde flexible intramedullary nailing for pediatric femoral fractures. MATERIAL AND METHOD: Nineteen cases (18 patients) with femur fracture at the age of 4 to 10 years (mean age 6.7) have been followed up over the minimum of one year. Under imaging intensifier, the fracture was temporarily reduced with manual traction, and 1 or 2 flexible nails were inserted at medial and lateral side of distal femur above the distal epiphysis. After two weeks of immobilization with long leg splint, joint motion was permitted. At 6-8 weeks, partial weight bearing was permitted, and at 10- 12 weeks, full weight bearing was permitted.
RESULTS
Time to radiologic union averaged 10.9 weeks. Limb length discrepancy ranged from 7mm of shortening to 6mm of overgrowth(mean ; 1.1mm of overgrowth), but there was no severe limb length discrepancy over 10mm. As another complications, there were one case of limited motion of knee joint and one case of broken nail.
CONCLUSION
We found that retrograde flexible intramedullary nailing is a safe, effective treatment for acute femoral shaft fractures in skeletally immature patients.

Citations

Citations to this article as recorded by

Treatment of Femoral Shaft Fracture with Interlocking Humeral Nail in Older Children and Adolescent
Kun-Bo Park, Hoon Park, Hyun-Woo Kim, Hui-Wan Park, Jae Young Roh
Journal of the Korean Fracture Society.2010; 23(2): 206. CrossRef

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