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Fixation For Femur Fractures in Children

In this study, the results of using stainless steel elastic nails to support unstable femoral shaft fractures in children are reported. Nails is a term to refer to a long stainless steel rod that is placed inside the femur (thigh bone).

The nails are elastic meaning they can be bent before inserting them into the bone. Once inside, this type of nail sits flat against the bone without changing shape. The same type of flexible stainless steel nail was used in two groups of children. The first group had a stable fracture. The second group had an unstable fracture.

Stable was defined by the type of fracture. In this study, a transverse (straight across the bone) or oblique (across at an angle) break was stable. Unstable fractures were either spiral (twisted apart) or comminuted (broken into more than two pieces).

The authors report the stainless steel nail worked well in both types of fractures. Patients healed with no difference in leg length from side to side. No one refractured. The was no difference in the rate of complications between the two groups.

The authors conclude flexible fixation of femoral shaft fractures in children is possible with stainless steel nails. They are stiffer and stronger than titanium nails. They work well for older children and teenagers who are too large for closed reduction (align bone without open surgery) and a full hip spica casting. And they can be used for unstable fractures.

References: Karl E. Rathjen, M.D., et al. Stainless Steel Flexible Intramedullary Fixation of Unstable Femoral Shaft Fractures in Children. In Journal of Pediatric Orthopaedics. June 2007. Vol. 27. No. 4. Pp. 432-441.

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