title: Complications of titanium elastic nails for pediatric femoral shaft fractures.
abstract: Limited data exist about complications of titanium elastic nails (TNs) for femur fracture management in pediatric patients. Thirty-nine patients with 43 femoral shaft fractures were identified whose average age was 6.0 years. There were 21 complications (1 intraoperative, 20 postoperative) in 43 femur fractures (49%). There were two major postoperative complications: one septic arthritis after nail removal and one hypertrophic nonunion. Minor postoperative complications were pain at the nails in 13 extremities, nail erosion through the skin in 4, and one delayed union. There was an association between the prominence of TNs and nail pain or skin erosion. Fracture angulation and outcome were associated with the patient's weight and size of the nails implanted. Technical pitfalls exist with this implant and can be minimized by leaving less than 2.5 cm of nail out of the femur and by using the largest nail sizes possible.
authors.affiliation: Department of Orthopaedic Surgery, Washington University School of Medicine and St. Louis Children's Hospital, Missouri 63110, USA. luhmanns@msnotes.wustl.edu
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Luhmann
authors.forename: Mario
authors.initials: M
authors.lastname: Schootman
authors.forename: Perry L
authors.initials: PL
authors.lastname: Schoenecker
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Dobbs
authors.forename: J Eric
authors.initials: JE
authors.lastname: Gordon
mesh_terms: D000704:Analysis of Variance; D001858:Bone Nails / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects*; D006801:Humans; D008297:Male; D018709:Statistics, Nonparametric; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium