title: Close Versus Limited Open Method of Ender's Nail Fixation in Paediatric Femoral Shaft Fractures.
abstract: BACKGROUND
  There are various surgical options for treating fracture of femoral shaft in children. Here we compare the results of close with limited open method of Ender's nails fixation of femoral shaft fractures in children.
  
  
  METHODS
  We studied 60 children with femoral shaft fractures in age group 5-15 years. Ender's nail fixation was done by close technique in 40 cases and in 20 cases by limited open technique.
  
  
  RESULTS
  The mean operative time was significantly high in limited open group being 64 minutes in comparison to 50 minutes in close group. There was no significant difference between close and limited open groups with respect to time for partial weight bearing and time for full weight bearing. Fracture united sooner in close group as compared to open group. Union was achieved in all patients within a mean of 11 weeks in close group in comparison to 12.4 weeks in open group. According to the Flynn criteria in close group 34 patients had excellent results, 6 had satisfactory and none poor. In limited open group outcome was excellent in 14 patients, satisfactory in 4 patients and 2 had poor result. There was no significant difference in outcome based on Flynn criteria between two groups.
  
  
  CONCLUSIONS
  Though operative time is more and healing is delayed in Ender's nail fixation by limited open technique, there is no statistical difference in final outcome as per Flynn criteria between close and limited open technique of Ender's nail fixation of femoral shaft fractures in children.
authors.affiliation: Department of Orthopaedics, Lumbini Medical College Teaching Hospital, Tansen Palpa, Nepal.
authors.forename: R
authors.initials: R
authors.lastname: Dwivedi
authors.affiliation: Department of Orthopaedics, Koshi Zonal Hospital, Biratnagar, Koshi, Nepal.
authors.forename: S
authors.initials: S
authors.lastname: Sah
authors.affiliation: Department of Orthopaedics, Koshi Zonal Hospital, Biratnagar, Koshi, Nepal.
authors.forename: M
authors.initials: M
authors.lastname: Dahal
authors.affiliation: Department of Orthopaedics, Civil Service Hospital, Kathmandu, Nepal.
authors.forename: P
authors.initials: P
authors.lastname: Acharya
authors.affiliation: Department of Orthopaedics, Nepalgunj Medical College, Kohalpur, Nepal.
authors.forename: S
authors.initials: S
authors.lastname: Gurung
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001858:Bone Nails; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005264:Femoral Fractures / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D061646:Operative Time; D016896:Treatment Outcome; D016474:Weight-Bearing
keywords: children; close technique; ender's nail; fracture shaft of femur; flynn criteria.