TREATMENT OUTCOMES IN FRACTURES OF THE FEMORAL SHAFT FRACTURES IN CHILDREN USING ELASTIC STABLE INTRAMEDULLARY NAILING

We evaluated the outcomes of fractures of the femoral shaft treated by elastic stable intramedullary nailing (ESIN). From 1994 to 1999, 100 children were treated. The mean age of the 65 boys and 35 girls was 8.7 years. The mean follow-up was 5.4 years. There were 30 type-AII fractures, 21 type-AIII, 17 type-AI, 13 type-BI, nine type-BII, four type-BIII and six type-CI. Implants were inserted using the ascending method in 92 patients and the descending method in eight. The mean period of implant insertion was 172 days. Steel implants (Medin) were used in 54 patients and titanium implants (Synthes) in 46. Evaluated according to Flynn, 86 patients had an excellent outcome, 13 a satisfactory outcome and one a poor outcome. The greatest limb length discrepancy was 3.2 cm. A steel implant was used in eight of the 13 patients whose results were merely satisfactory and in the patient who had a poor outcome. There were no pyogenic complications. In five patients, the inserted implant required shortening during treatment. We believe that in 5 to 12-year-old patients the ESIN method with titanium implants can be used to treat femoral shaft fractures.