Results of the Pediatric Shaft Femur Fracture Treated with Closed Rigid Lateral Trochanteric Entry Intramedullary Nail in North Indian Population

Rajeev Kansay, Saurabh Vashisht, Siddharth Kothari, Ashwani Soni, Rohit Jindal, Sudhir Garg
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Abstract

Objectives The femoral shaft fractures constitute 1.6% of the pediatric fractures. Intramedullary nailing is a common mode of fixation in older children and adolescents. The rigid intramedullary locking nail is a preferred choice over flexible nails in overweight patients and children older than 11 years of age. The adolescent age group with skeletal immaturity deserves special attention from the surgeons because of grave complications like avascular necrosis of the femur head and angular deformities. The aim of this study is to report the outcome of an adolescent femur shaft fracture treated with a rigid intramedullary interlocking nail in North Indian patients. Materials and Methods This is a retrospective analysis performed by retrieving records of 19 patients. Patients with open fractures, polytrauma and neurovascular injuries were excluded. The preoperative and post-operative radiographic orthogonal views were analyzed to assess parameters like alignment, union and avascular necrosis (AVN). Results The mean age was 12.3 years. The mean follow-up was 1.5 years. The average time for union was 8 weeks. All the fractures were united in an acceptable alignment and rotation. There was no avascular necrosis, angular deformity and infection. The mean femur length discrepancy was 7 mm. Conclusion The rigid intramedullary interlocking nail is a valuable option for the fixation of femoral shaft fractures in an adolescent age group with a good union rate and minimal complications.
封闭刚性外侧粗隆髓内钉治疗北印度儿童股骨骨干骨折的疗效
目的股骨干骨折占小儿骨折的1.6%。髓内钉是大龄儿童和青少年常用的固定方式。在超重患者和11岁以上的儿童中,刚性髓内锁定钉是比柔性钉更好的选择。青少年骨骼发育不成熟,由于其严重的并发症如股骨头缺血性坏死和角畸形,值得外科医生特别关注。本研究的目的是报告北印度患者用刚性髓内联锁钉治疗青少年股骨骨干骨折的结果。材料与方法对19例患者进行回顾性分析。排除开放性骨折、多发外伤及神经血管损伤患者。分析术前和术后x线片正交视图以评估对齐、愈合和无血管坏死(AVN)等参数。结果患者平均年龄12.3岁。平均随访时间为1.5年。平均结合时间为8周。所有骨折均以可接受的方向和旋转愈合。无血管坏死、角畸形、感染。股骨平均长度差异为7mm。结论刚性交锁髓内钉是治疗青少年股骨干骨折的一种有价值的方法,愈合率好,并发症少。
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