Surgical Management Of Fractures Of The Femur Shaft In Children And Adolescents Using Flexible Nails - A Prospective Study

In this prospective study 25 patients, aged 6 to 14 years, with fractures of the shaft of the femur were treated with retrograde flexible intramedullary nailing in the department of Orthopaedics at MMIMSR Hospital (Maharishi Markandeshwar Institute of Medical Sciences and Research) in the period from October 2012 to December 2013. Children and adolescents aged between 6 to 14 years were included in the study with the average age being 10.16 years. Maximum numbers of patients were between 9 to 11 years of age and 64% of the patients were boys. RTA constituted for 60% of the fractures in our study and fall 40%. All fractures were closed 16 (64%) were transverse, 3 (12%) were oblique and 6 (24%) were spiral fractures. 23 (92%) cases were located in the middle 1/3rd and 2 (8%) in the proximal 1/3rd of the femoral shaft. A thorough clinical and radiological examination was performed. All the patients were prepared and operated as early as possible once the general condition was stable and the patient was fit for surgery. All the patients were operated on a fracture table. Closed reduction was done in 24 cases and fracture site was opened in one case. In one case the patient had an ipsilateral fracture of the femur shaft and the tibia. On table open reduction was done and the patient was operated with flexible nailing at same time. None of the patients were immobilized postoperatively. Patients were allowed to do quadriceps and knee bending exercise in the 1st postoperative week.