title: [Fracture of the femoral diaphysis in children. Ascending or descending centro-medullary nailing? A choice of principle or of necessity?].
abstract: Over a period of 4 years, 40 children between the ages of 6 and 14 years (mean: 10 years) were treated for a fracture of the femoral shaft (39 closed fractures and 1 Cauchoix type I open fracture) by flexible medullary nailing, either ascending (5 cases) or descending (35 cases). Although it is classical to use the ascending route described by the Nancy team, the sub-trochanteric descending route was preferred for its simplicity; non-involvement of the knee by the insertion of the nail allows earlier autonomy in children. The results have been found to be satisfactory; no complications related to the method were observed. The biomechanical principles are also conserved.
authors.affiliation: Service de Chirurgie Pédiatrique (Service Dr Gross), Hôpital Delafontaine, Saint-Denis.
authors.forename: D
authors.initials: D
authors.lastname: Bourdelat
authors.forename: M
authors.initials: M
authors.lastname: Sanguina
mesh_terms: D000293:Adolescent; D001696:Biomechanical Phenomena; D001858:Bone Nails; D002648:Child; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000473:pathology / Q000534:rehabilitation / Q000601:surgery*; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D005684:Gait / Q000502:physiology; D006801:Humans; D007870:Leg Length Inequality / Q000209:etiology; D008297:Male; D014025:Titanium; D014143:Traction; D016474:Weight-Bearing
chemical_list: D014025:Titanium
vernacular_title: Fracture de la diaphyse fémorale chez l'enfant. Embrochage centro-médullaire ascendant ou descendant? Un choix de principe ou de nécessité?