Comparison of SIGN Pediatric and Fin Nails in Pediatric Diaphyseal Femur Fractures: Early Clinical Results

OBJECTIVES:The purpose of this study was to evaluate the effectiveness of SIGN Pediatric and Fin nails in treating pediatric diaphyseal femur fractures. DESIGN:Prospective case series. SETTING:Level I trauma center from 2010 to 2013. PATIENT/PARTICIPANTS:Eighteen patients (13 male and 5 female) with pediatric diaphyseal femur fractures who did not achieve skeletal maturity. INTERVENTION:Femoral nailing was done using either SIGN Pediatric or Fin nail with hand-reaming without using bone-grafting or image intensifier. MAIN OUTCOME MEASUREMENTS:Patients were evaluated for infection, radiographic parameters, range of movements, time to weight-bearing (partial and complete), revision surgery (if needed), and complications. RESULTS:The average age of patients was 10.2 (±2.1) (range6–13) years and average time between injury and surgery was 13 (1–112) days. Fin nail was used in 13 patients, and Pediatric nail in 5 patients. There were no infections in either group. The average time for full weight-bearing was 7.07 weeks in the Fin nail group, and 8.4 weeks in the Pediatric nail group. No repeat surgeries were performed, and there was no case of avascular necrosis of femur head, limb length discrepancy, or any other complication. CONCLUSIONS:SIGN Pediatric and Fin nails are an effective treatment modality for pediatric diaphyseal femur fractures with excellent fracture healing with no major complications. LEVEL OF EVIDENCE:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.