J Korean Fract Soc.  2010 Apr;23(2):206-212. 10.12671/jkfs.2010.23.2.206.

Treatment of Femoral Shaft Fracture with Interlocking Humeral Nail in Older Children and Adolescent

• Park KB
• Park H
• Kim HW
• Park HW
• Roh JY

• KMID: 1461549
• DOI: http://doi.org/10.12671/jkfs.2010.23.2.206

Abstract

PURPOSE
To evaluate the results of interlocking humeral nail for femur shaft fractures through the greater trochanter in older children and adolescent.
MATERIALS AND METHODS
Eleven femoral shaft fractures in ten patients were selected. They were consisted of 9 boys and 1 girl. Two patients had osteogenesis imperfecta and one patient had a simple bone cyst as an underlying disease. 7 cases were right side and 4 cases were left side. The mean age at the time of operation was 12 years and 7 months (8 years 11 months~15 years 7 months). The mean follow-up period was 21 months and interlocking humeral nail was inserted at the greater trochanter in all patients.
RESULTS
All patients had a complete bony union without any complication such as infection, nonunion, leg length discrepancy and metal failure. Avascular necrosis of femoral head and coxa valga were not developed in all patients.
CONCLUSION
Intramedullary nailing through the greater trochanter using interlocking humeral nail is effective and safe treatment for the femoral shaft fracture in older children and adolescents.

Keyword

Children; Adolescent; Femur shaft fracture; Interlocking humeral nail

MeSH Terms

Adolescent
Bone Cysts
Child
Coxa Valga
Femur
Follow-Up Studies
Fracture Fixation, Intramedullary
Head
Humans
Leg
Nails
Necrosis
Osteogenesis Imperfecta

Figure

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  Fig. 1 The design of unreamed humeral nail shows the bending of proximal nail end by 5° medially.

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  Fig. 2 An 11+9 years old boy (Patient No.3) had a shaft fracture of the femur. Preoperative anteroposterior and lateral radiographs (A) show the proximal 1/3 shaft spiral fracture. Immediate postoperative anteroposterior and lateral radiographs (B) show the internal fixation with unreamed humeral nail via the tip of the greater trochanter. Postoperative 3 months follow-up anteroposterior and lateral radiographs (C) show bony union without complications. The boy has neither subjective nor objective discomfort with full weight bearing gait. Postoperative 15 months Scanogram (D) after hardware removal show no leg length discrepancy deformity and distortion of the proximal femoral area.

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  Fig. 3 A 13+1 years old boy (Patient No.10) had a simple bone cyst in the femur (A). He had a pathologic fracture of the femur shaft during running (B). Immediate postoperative anteroposterior and lateral radiographs (C) show the internal fixation with unreamed humeral nail via the tip of the greater trochanter. Postoperative 4 months follow-up anteroposterior and lateral radiographs (D) show bony union.

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