[Open reduction and intramedullary fixation through minimal incision with Ender nails in femoral fractures of children aged from 6 to 16 years].
OBJECTIVE
We evaluated functional and radiologic results of the treatment in patients aged 6 to 16 years, who underwent indirect reduction with Ender nails through minimal incisions for troublesome femoral fractures.


METHODS
We treated femoral fractures of 20 children (3 girls, 17 boys; mean age 10 years; range 7 to 15 years) by indirect reduction and relative stabilization with Ender nails through mini-incisions. Indications for intramedullary nailing were the presence of multiple fractures, accompanying head injuries, neurological or pathologic disorders. According to the Müller classification, there were two 32A1, three 32A2, nine 32A3, three 32B1, and three 32B2 fractures. Secondary callus formation was monitored with follow-up serial x-ray examinations. Range of motion of the hips and knees, leg length discrepancy, and the femoral anteversion were examined clinically. The mean follow-up was 30.5 months (range 24 to 46 months).


RESULTS
Surgery was performed after a mean of 4.5 days of admission. The mean hospital stay was 12 days. Full weight-bearing was achieved after a mean of 69 days (range 45 to 98 days). Union was obtained in all patients without any complications. Ender nails were removed surgically after a mean of 10.3 months (range 6 to 16 months). The femoral anteverison was more than 10 degrees in three patients. The mean leg length shortening was 0.35 cm (range 0 to 1 cm).


CONCLUSIONS
Intramedullary nailing of femoral fractures with Ender nails through minimal incisions provides a safe and adequate stabilization in cases in which conservative treatment is likely to fail, and in multiple fractures, open fractures, coexistent head injuries, in mentally-retarded children, and in children aged from 6 to 16 years.
Kalenderer
Onder
O
Department of Orthopedics and Traumatology (2. Ortopedi ve Travmatoloji Kliniği), Izmir SSK Training Hospital, Turkey.
Ağuş
Haluk
H
Sanli
Coşkun
C
D000293:Adolescent; D001858:Bone Nails; D002648:Child; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome