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Antegrade rigid nailing through the tip of the greater trochanter for pediatric femoral shaft fractures

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Abstract

The aim of this work was to evaluate the results of rigid nailing of pediatric femoral shaft fractures inserted antegrade through the tip of the greater trochanter. Twenty-three femoral shaft fractures in 23 children were fixed with rigid interlocking nails inserted through the tip of the greater trochanter at Mansoura Emergency Hospital in the period between June 2009 and August 2011. The average age of the patients at the time of injury was 12.6 years (range 9.2–15 years). The final follow-up radiographs were assessed for evidence of avascular necrosis (AVN) of the femoral head and any deformity of the proximal femur, the neck–shaft angle, the articulotrochanteric distance, and the femoral neck diameter. Patients were followed to a mean period of 31 months (range from 25 to 36 months) postoperatively. All fractures united in a range of 9 weeks (from 8 to 13 weeks) with no limb length discrepancy more than 2 cm and no clinically evident rotation in either direction; no case had a vascular necrosis of the femoral head or significant proximal femoral deformity by the final follow-up. Fixation of fractures of the shaft of the femur in children with rigid interlocking nails inserted through the tip of the greater trochanter is a rigid way for fixation controlling rotation and length. It is a safe technique without causing AVN of the femoral head or proximal femoral deformity.

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Acknowledgments

This study have been approved by the ethical committee in Mansoura University and performed in accordance with the pertinent ethical guidelines (i.e., Declaration of Helsinki, as laid down in 1964 and revised in 2008), and informed consents were taken from parents of all patients.

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Authors and Affiliations

  1. Orthopedic Department 2, Mansoura University, Mansoura, Egypt

    Hatem S. A. Elgohary

  2. Orthopedic Department 2, Mansoura University Hospitals, Mansoura, Egypt

    Wael A. El Adl

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  1. Hatem S. A. Elgohary
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  2. Wael A. El Adl
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Correspondence to Hatem S. A. Elgohary.

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Elgohary, H.S.A., El Adl, W.A. Antegrade rigid nailing through the tip of the greater trochanter for pediatric femoral shaft fractures. Eur J Orthop Surg Traumatol 24, 1229–1235 (2014). https://doi.org/10.1007/s00590-013-1382-z

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  • DOI: https://doi.org/10.1007/s00590-013-1382-z

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