title: Complications of pediatric femur fractures treated with titanium elastic nails: a comparison of fracture types.
abstract: The purpose of this study was to analyze complications seen in children with femur fractures stabilized with titanium elastic nails, comparing their use in stable and unstable fracture patterns. A retrospective review was performed on 39 consecutive children with femur fractures treated with titanium elastic nails. Patients with comminuted or long oblique fractures were classified as having "length-unstable" fractures. Patients were analyzed qualitatively for any predictive factors or treatment variables that increased the risk of complications. There were 24 patients with complications (62%). Eight patients (21%) underwent unplanned surgery prior to complete fracture union. Six of the eight requiring unplanned surgery were treated for "length-unstable" fractures. The complications that required unplanned surgery for either prominent nails or loss of reduction occurred more commonly in unstable non-transverse fracture patterns. The authors conclude that in patients with "length-unstable" femur fractures, consideration should be given to methods of treatment other than titanium flexible intramedullary nails.
authors.affiliation: Department of Orthopaedics, University of Colorado Health Science Center, School of Medicine, Denver, CO 80218, USA. sink.ernest@tchden.org
authors.forename: Ernest L
authors.initials: EL
authors.lastname: Sink
authors.forename: Jane
authors.initials: J
authors.lastname: Gralla
authors.forename: Michael
authors.initials: M
authors.lastname: Repine
mesh_terms: D001858:Bone Nails; D002648:Child; D005264:Femoral Fractures / Q000145:classification* / Q000503:physiopathology / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D010146:Pain / Q000209:etiology; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D014025:Titanium
chemical_list: D014025:Titanium