TITLE

Limb Geometry After Elastic Stable Nailing for Pediatric Femoral Fractures

AUTHOR(S)
Hamed Salem, Khaled; Keppler, Peter
PUB. DATE
June 2010
SOURCE
Journal of Bone & Joint Surgery, American Volume;Jun2010, Vol. 92-A Issue 6, p1409
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Elastic stable intramedullary nailing has become a popular treatment for pediatric long–bone fractures. However, early limb malalignment and length differences may occur in children with femoral fractures who are managed with this procedure. Methods: We prospectively followed sixty–eight children (mean age, 5.6 years) who were managed with elastic stable intramedullary nailing for the treatment of a unilateral femoral shaft fracture in order to evaluate early angular or rotational malalignment or limb–length discrepancy. The average body weight was 21 kg (range, 10 to 45 kg). There were fifty–seven A0/ASIF Type–A fractures and eleven Type–B fractures. Malalignment was assessed with use of radiographs, computed tomography, or navigated ultrasound examination after four to seven months to evaluate the short–term result of fixation and to eliminate changes caused by later bone remodeling. Results: The mean femoral length difference was 0.5 mm of femoral lengthening. Only eleven patients (16%) had a limblength discrepancy of >10 mm. Mechanical axial deviation of >50 occurred in one patient. However, the mean femoral rotational angle difference was 14.5°. Thirty–two children (47%) had ⤢15° of torsional malalignment. Conclusions: Elastic stable intramedullary nailing can provide satisfactory results in terms of limb length and axial alignment, but a high rate of early torsional malalignment may be seen. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
51403994

 

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