TEN versus external fixator in the management of pediatric diaphyseal femoral fractures: evaluation of the outcomes

  • Giuseppe Rollo
  • Pasquale Guida
  • Michele Bisaccia
  • Paolo Pichierri
  • Marco Filipponi
  • Riccardo Maria Lanzetti
  • Auro Caraffa
  • Alessandro Stasi
  • Valentina Russi
  • Domenico Lupariello
  • Luigi Meccariello
Original Article • LOWER LIMB - FRACTURES



Over the last 20 years, the incidence of pediatric diaphyseal femoral fractures was increased, due to changes in the children’s daily activities. The healing times are different according to the chosen treatment and to other factors such as age, type of fracture, involvement of the soft tissues, and concomitance with other injuries.

Materials and methods

From 2000 to 2015, 38 pediatric patients with diaphyseal femoral fractures were surgically treated and enrolled in the study. The average age of the patients was between 3 and 15 years. Twenty-two patients were treated with endomedullary titanium nails (TEN) and the other 16 with external axial fixators. Comparing the two groups, radiographic images were taken to assess the fracture reduction and consolidation.


The average follow-up was 14 months. The average time needed to remove the TEN nails was 5 months; while 2.5 months was the time to remove the external fixator. At the final follow-up, there were no differences between two groups in term of significant rotation defects, angulation, growth, and/or nonunion.


This study showed that TENS and external fixation have similar results in term of fracture healing and complication, even if patients treated with TENS are more satisfied.


Pediatric fractures Femoral fractures TEN External fixator 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Human and animal rights

This type of study does not require any statement relating to studies on humans and animals. All patients gave the informed consent prior to being included into the study. All procedures involving human participants were in accordance with the 1964 Declaration of Helsinki and its later amendments.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Giuseppe Rollo
    • 1
  • Pasquale Guida
    • 2
  • Michele Bisaccia
    • 3
  • Paolo Pichierri
    • 1
  • Marco Filipponi
    • 1
  • Riccardo Maria Lanzetti
    • 3
    • 6
  • Auro Caraffa
    • 3
  • Alessandro Stasi
    • 1
  • Valentina Russi
    • 4
  • Domenico Lupariello
    • 5
  • Luigi Meccariello
    • 1
  1. 1.Department of Orthopedics and TraumatologyVito Fazzi HospitalLecceItaly
  2. 2.Department of Orthopedics and TraumatologyPediatric Hospital Santobono PausiliponNaplesItaly
  3. 3.Division of Orthopedics and Trauma Surgery, S. Maria della Misericordia Hospital PerugiaUniversity of PerugiaPerugiaItaly
  4. 4.Orthopaedics and Traumatology DepartmentUniversity of PalermoPalermoItaly
  5. 5.University of Rome La SapienzaRomeItaly
  6. 6.U.O.C. Orthopedics and Traumatology Department, SM Misericordia HospitalUniversity of PerugiaPerugiaItaly

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