The Operative Stabilization of Pediatric Diaphyseal Femur Fractures with Flexible Intramedullary Nails: A Prospective Analysis

Seventy-eight diaphyseal femur fractures in 77 children were stabilized with flexible intramedullary nails. The patients ranged in age from 2 + 9 to 18 years. All patients had open femoral growth plates at the time of fixation. Eleven percent of the fractures had an average varus or valgus malalignment of 6°. Eight percent of the fractures had an average anterior or posterior malalignment of 8°. Eight percent of the patients had a rotational malalignment that averaged 8°. Sixty-eight percent of the children had equal leg lengths at follow-up. There were four unscheduled reoperations, but no major complications; all fractures united. The results obtained using flexible intramedullary nails for the stabilization of select pediatric diaphyseal femur fractures are comparable to non-operative methods of treatment, but with less disruption to family life and a shorter hospitalization.