title: Fixator-augmented flexible intramedullary nailing for osteopenic femoral shaft fractures in children.
abstract: Children with underlying metabolic bone diseases, such as osteogenesis imperfecta and spastic cerebral palsy, pose a challenge in the treatment of femoral shaft fractures. We performed flexible intramedullary nailing with supplemental monolateral external fixation in a subgroup of such patients. The external fixator assists in controlling angulation and rotation at the fracture site, and avoids the need for supplemental casting with its associated problems such as skin breakdown and difficulty with personal hygiene. We describe the surgical technique, pitfalls, and outcomes in a series of four patients with underlying osteopenia treated with external fixator-augmented flexible nailing for femoral shaft fractures.
authors.affiliation: Department of Orthopaedic Surgery, New Jersey Medical School, Rutgers University, Newark, New Jersey, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Kong
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sabharwal
mesh_terms: D001851:Bone Diseases, Metabolic / Q000150:complications*; D001858:Bone Nails; D002648:Child; D002675:Child, Preschool; D016267:External Fixators; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D006801:Humans; D008297:Male; D010027:Osteotomy