Interlocking Intramedullary Nailing of Femoral-Shaft Fractures in Adolescents: Preliminary Results and Complications

Thirty-one femoral-shaft fractures in 30 patients were treated with interlocking intramedullary nails. The 19 boys and 11 girls ranged in age from 10 to 15 years (average age 12 + 3 years) at the time of injury. All fractures united, and the average leg-length discrepancy (comparing the injured to the uninjured extremity) was 0.51 cm. Two patients had overgrowth of >2.5 cm; none had angular or rotational malunions. One patient developed asymptomatic segmental avascular necrosis of the femoral head, which was not seen on radiographs until 15 months after injury. All nails were removed at an average of 14 months after injury; no refracture or femoral neck fracture has since occurred. Intramedullary nailing is a reasonable alternative for the treatment of isolated femoral-shaft fractures in older adolescents and in younger adolescents with multiple trauma.