Intramedullary nailing of femoral shaft fractures in adolescents.

Twenty-two femoral shaft fractures in 20 patients aged 10-14 years with open physes treated with closed reamed intramedullary nailing were studied retrospectively. Follow-up averaged 26.7 months in 18 of 20 patients. Eleven additional patients with 11 femoral shaft fractures treated with casting and traction were included for comparison of hospitalization time, cost, and time to mobilization. All of the fractures treated with an intramedullary nail healed without malunion or leg length inequality, and there was no evidence of growth plate arrest. The patients treated with an intramedullary nail had statistically significant shorter hospitalizations and shorter times to mobilization, and treatment had an estimated cost of less than half of traction treatment. Results of this study suggest that closed intramedullary nailing of femur fractures in adolescents is an effective treatment option.