TREATMENT OF PEDIATRIC FEMORAL SHAFT FRACTURES - TITANUM ELASTIC INTRAMEDULLARY NAILS VS PLATE.

There are two main types of operative treatment for femoral shaft fractures in children with age 6 to 15 years old: Osteosynthesis by Titanium Elastic intramedullary nails (TEN) and osteosynthesis by plate. In our study we analyzed 137 patients from 6 to 15 years of age with pediatric femoral shaft fractures and divided them into two groups according to methods of osteosynthesis: 76 patients in "TEN group" and 61 in "Plate group". According to Flynn's scoring criteria for both groups there were excellent result for 106 patients (77%) from 137, satisfactory result for 23 patients (17%) and 8 patient with poor result (6%). There was not significant statistical difference between groups. There was significant difference between groups according to operation duration and hospital stay. These times were much shorter for the TEN group than for the Plate group. Time for starting partial weight bearing was same for both groups. For patients treated with TEN with satisfactory and poor outcome (total 32 patients) the main problem was different degree of irritation of soft tissues from nail ends. Not one patient had the same problem in who was inserted nail "end cup" (total 15 patients). Fixation by TEN can be used in some cases of heavy children. Taking everything said before into consideration, we concluded that fixation by TEN is preferable than fixation by plate and can be used as a first choice of treatment in this age group of children with femoral shaft fractures.