Pediatric femoral fractures: a comparison of compression plate fixation and flexible intramedullary nail
The proper placement of both intramedullary nails
is seen, and there is no evidence of osteolytic lesions in either of the tibias.
In older literature of flexible intramedullary nail
fixation of displaced midshaft clavicular fractures, the values calculated were 98.3, 98 ranging 93-100, 81 ranging 46-100, 95.3 [+ or -] 3.9, 95.2 ranging 86.5-97.0 and 97 [+ or -] 4.2.
In the group with AFF, intraoperative femoral fracture during intramedullary nail
insertion occurred in 11.8% (2 cases) (Figure 1), and one plate failure occurred (5.9%); there were no nail failures.
As shown in this prospective study, majority of subtrochanteric fractures can be treated with minimally invasive approach with the availability of second generation of intramedullary nails
. However, improper reduction with resultant mal-union or non-union, cephalic screw cutting out, z-effects or reverse z-effects are not uncommon after intramedullary nailing of comminuted fractures as observed in the present study.
Fifty-three consecutive patients with femoral intertrochanteric fractures (24 right and 29 left) who underwent surgery with InterTan intramedullary nail
were included in our study.
The remaining 39% of patients were treated with intramedullary nail
(17%), Ilizarov appartus (13%) and Sarmiento cast (9%), which eventually led to the complete union .
Zhao, "Tibial lengthening over an intramedullary nail
in patients with short stature or leg-length discrepancy: a comparative study," International Orthopaedics, vol.
The intramedullary nail
, with its location close to center of femur, can tolerate bending and torsional loads better than plates and the locking mechanism provides less tensile and shear stress than plates.
Using one of the Engineering Tools, Finite Element Analysis (FEA) three dimensional study of the strain in the proximal portion of the standardized femur implanted with a retrograde intramedullary nail
in response to simplified axial, bending and compression loading, The authors found that varying the length of the nail alters the strain distribution in the proximal femur geometry and that increasing the nail length introduces more stress shielding into the proximal region .
The current osteosynthesis plate and intramedullary nail
systems are proven to be safe products but, nevertheless, a subsequent locking option provides further safety, especially in cases of poor bone quality.
Complications of elastic stable intramedullary nail
fixation of pediatric femoral fractures, and how to avoid them.