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Pocdiatric Femoral Fractures Hasson A/-Sayed, M.D
Titanium Elastic Nail Fixation
for Paediatric Femoral
Shaft Fractures
Hassan Al-Sayed, M.D.
ABSTRACT iod from January 2000 to Sep-
In the periodfrom January 2000 to September 2004, 25 children
tember 2004. The age incidence
with 25 femoral shaft fractures were treated by retrograde titanium in this series ranged from 8
elastic nail fixation in the Paediatric Orthopaedic Unit of Al-Razi years to 12.5 years (an average
Orthopaedic fIo.spital in Kuwait. Two nails of the same diameter were of 10.5 years),. 22 children
used for thefixation of each femoral shaft fracture using a fracture
table and under image intensifier control. Postoperatively, early (88%) were males and 3 (12%)
graduated weight bearing was allowed and the children were followed were females. All the fractures
up clinically and radiographically. The nails were removed after in this series were recent closed
fracture consolidation. Our results are compatible with those of the fractures except one malunited
largest series of titaitium elastic nails with universal union of the
fractures, no refractures, occasional skin irritalion by the nails and fracture referred to our unit 10
occa.siona1 minor lower limb length discrepancies. weeks after injury. The fracture
Key words : Children, Femoral, Fracture, Fixation, Elastic, Nail. pattern was transverse or short
oblique in 24 cases and com-
minuted in one case. All the
INTRODUCTION: problems and complications fractures occupied the middle
have led to the introduction of third of the femur.. The me-
ost paediatric fe-
flexible intramedullary fixation chanism of injury included pe-
moral shaft frac-
as an adaptable technique for destrian vehicle accidents
tures are treated
the stabilisation of femoral (60%), motor vehicle accidents
conservatively with good long
shaft fractures in patients with (28%) and falls (12%). There
term results('). Less than per-
immature skeleton('). were no associated injuries in
fect reductions quickly remodel
straight'". The vroblem arises
- Ender's nails and titanium this series. All the fractures in
when operative stabilisation be- elastic nails are the two types of this series were treated by retro-
comes necessary due to failure flexible intramedullary nails grade titanium elastic nail fixa-
to obtain or maintain an accep- used over the years(7).The aim tion using two nails of equal
table reduction of the fracture of this study is to present the diameter for each fracture.
by conservative methods. The experience of the Paediatric
previous methods of operative Orthopaedic Unit of Al Razi The surgical technique was as
stabilisation of paediatric fe- Orthopaedic Hospital in Ku- follows :
moral shaft fractures included wait about titanium elastic nail Under general anaesthesia,
external fixation, compression fixation for paediatric femoral the child was positioned supine
plating and rigid intramedul- shaft fractures. on a fracture table with a
lary nailing. Theses methods traction boot and traction was
were associated with some pro- applied to the injured extremity
MATERIAL & METHODS :
blems and complications like followed by adjustment of the
pin tract infections, loss of The material of this study image intensifier (C-arm) for
reduction, refracture after me- consisted of 25 children with 25 obtaining anteroposterior and
tal removal, growth arrest and femoral shaft fractures treated lateral views for the injured
avascular necrosis of the capital by titanium elastic nail fixation femur intraoperatively. The
femoral epiphysis(2-6).These in the Paediatric Orthopaedic nail diameter was determined
Paediatric Orthopaedic Unit, A/ Unit of Al Razi Orthopaedic on preoperative radiographs
Razi Orfhopaedic Hospital, Kuwait. Hospital in Kuwait in the per- (Fig. 1). After sterilisation and
Pan Arab J. Orth. Trauma - Vol. (10) No. (I)/ January 2006 7
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