[Moderate results of the treatment of femoral shaft fractures in children using intramedullary fixation].
OBJECTIVE
To evaluate the results of treatment of femoral shaft fractures in children with intramedullary nailing.


METHODS
Retrospective.


METHODS
Department of Surgery, University Hospital Utrecht, Department of Paediatric Surgery, Wilhelmina Children's Hospital, Utrecht.


METHODS
Between 1982 and 1993, 27 femoral shaft fractures in 27 patients under the age of 16 were treated by intramedullary nailing. The charts and radiographs of these patients were reviewed and 24 patients were seen for follow-up examination (mean 7.5 years). Leg length was measured radiographically and anteversion of the affected and normal femora was determined by a standard computed tomography (CT) study.


RESULTS
The average hospital stay was 34 days. There were no postoperative complications. At follow-up 10 patients had a leg length discrepancy < 1 cm and a rotational deformity < 10 degrees. Three patients had a shortening of the injured leg > 1 cm (max. 1.7 cm), in 6 patients the injured leg was more than 1 cm longer (max. 3.5 cm). The difference in rotation between fracture side and unaffected side was > 10 degrees in 9 patients. In 6 patients this was due to increased exorotation (max. 22 degrees) and in 3 patients to increased endorotation (max. 27 degrees). Iatrogenic injury of the epiphyseal line was not seen.


CONCLUSIONS
Regarding leg length differences and rotational deformities intramedullary nailing was not superior to the known results of conservative treatment. The indication for operation should be carefully considered and during an operation there should be perfect control of reduction.
van Meeteren
M C
MC
Academisch Ziekenhuis, afd. Heelkunde, Utrecht.
van Riet
Y E
YE
Hoogbergen
M M
MM
Pull ter Gunne
A J
AJ
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005264:Femoral Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary; D017102:Fracture Healing; D006801:Humans; D016916:Joint Deformities, Acquired / Q000209:etiology; D007870:Leg Length Inequality / Q000209:etiology; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
Matig resultaat van de behandeling van femurschachtfracturen bij kinderen door intramedullaire fixatie.