Effect of titanium elastic nailing surgery on the femoral development in pediatric femoral fractures

Purpose: The aim of this current study was to investigate the effect of titanium elastic nailing surgery following the pediatric femoral shaft fractures on the long-term pediatric femoral development. Materials and Methods: Thirty-five patients with a mean age of 62.1 months(15-160) who underwent surgery with titanium elastic nailing following unilateral femoral shaft fracture in our clinic were included in this study..At the last postoperative visit, patients were further evaluated through the physical examination and comparative femoral anterior posterior and lateral radiographs.The difference in length of the lower extremities and deformities in the frontal and sagittal plane, collodiaphyseal angle, mechanical distal femoral lateral angles were all calculated and compared with the intact femoral length and angles. Results: The mean follow-up period in our study was 69.8 months (36-120).The mean fracture union time period was 11.2 weeks(8-13).The mean implant removal time was 5.1months(2-12).At the last follow-up, 1 patient(2.8%) had 5mm shortening in the femur lenght while 3 patients' femurs(8.5%) got longer with the average of 6 +/- 4mm compared to that of the intact femur. In 8 patients (22.8%), varus angulation was measured as 4.7 degrees +/- 2.1 at the fracture line. Conclusion: The treatment of femoral shaft fractures with titanium elastic nailing surgery has a limited effect on pediatric femur development in the long term. Surgical treatment of pediatric femoral fractures with titanium elastic nailing is a simple and safe method of treatment with low long-term complications.