Femoral shaft fractures treated with stainless steel flexible nails in children aged between 5 and 12 years at the HUSVP: a two-year follow-up

Abstract

Purpose: The purpose of this study is to show our experience with stainless steel flexible nails in the treatment of femoral shaft fractures in children aged between 5 and 12 years and to observe if the type of material used for nails affects the results.

Materials: A prospective, descriptive study of a series of cases was performed to evaluate patients treated at the Hospital Universitario San Vicente de Paúl (HUSVP) who had been followed up for at least 24 months.

Results: The study group was composed of 48 patients, with an average age of 8.6 years. According to the AO classification, the most common type of fracture was 32A3.2 (61%). The average follow-up period was 43 months. The alterations observed were six cases of clinical length discrepancy, two cases of overgrowing, four cases of shortening, and two malunions in valgus. These alterations had no repercussion in the children's function. The follow-up is the main strength of this study, as it demonstrated that, 2 years after surgery.

Conclusion: The results with stainless steel nails are as good as those with titanium nails with a shorter follow-up as reported in the literature. Given the high costs of osteosynthesis material in our country, the results of this study provide a less expensive alternative. Level of evidence IV, case series.

Fig. 1

Case report: A 7-year old patient, left femoral shaft fracture AO 32A3.2 caused by road traffic accident as pedestrian (a), (b). A closed reduction was performed. Fixation of retrograde stainless steel flexible nails (c), (d). Advanced bony callus after 16 weeks (e). The osteosynthesis material was removed 5 months after the fracture. Radiographic control after a 2-year follow-up. (f), (g)