Intramedullary Nailing Compared with Spica Casts for Isolated Femoral Fractures in Four and Five-Year-Old Children

Abstract

To discuss the best method of management of femoral fractures in four and five year old children. Methods:A cohort of 100 children with 100 fractures (non-pathological; not involving condyles or cervicotrochanteric area; No Associated injuries; and not open fractures) were prospectively examined (50 patients managed with spica casts and another 50 patients managed with intramedullary nailing). Radiographic and clinical outcomes were compared between the groups. Statistical analysis of the results has been done. Results:The mean follow-up was 12 ± 4.3 months, the mean hospital stay was 3.2 ± 1.1 days for IMN and 1±1 for spica cast, and the mean time to nail removal was 22.3 ± 10.2 weeks. The mean time to union was 45 ± 15 days in IMN and 55 ± 20 days ln spica cast. Union was significantly correlated to age (p=0.000) and fracture shape (p = 0.005), but not to the fracture level, nature, or mechanism. Conclusion:IMN is a dependable, safe, and cost-effective alternative to traction and cast in four and five year old children.