Closed Ender nailing of femur fractures in older children.

Twenty-eight patients ranging from 8 to 13 years old were treated at Childrens Hospital of Alabama for diaphyseal femur fractures. We studied two groups: 14 patients (Group I) were treated by conventional 90-90 balanced skeletal traction with late spica cast application; 14 patients (Group II) with multiple associated injuries or hyperkinetic problems were treated with closed retrograde Ender nailing. Groups I and II compared closely with regard to age, sex, fracture type and location, and mechanism of injury. The alignment, leg length, length of hospitalization, and length of therapy were analyzed. Our experience indicates that closed retrograde Ender nailing of diaphyseal femur fractures is an ideal technique where operative reduction and stabilization are indicated in older children. The technique yields results superior to conventional methods of treatment, with the advantage of early discharge from the hospital and return to school.