Treatment of Femoral Shaft Fracture with Interlocking Humeral Nail in Older Children and Adolescent

Kun-Bo Park; Hoon Park; Hyun-Woo Kim; Hui-Wan Park; Jae Young Roh

doi:10.12671/jkfs.2010.23.2.206

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Park, Park, Kim, Park, and Roh: Treatment of Femoral Shaft Fracture with Interlocking Humeral Nail in Older Children and Adolescent

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2010; 23(2): 206-212.

Published online: 30 April 2010

DOI: https://doi.org/10.12671/jkfs.2010.23.2.206

Treatment of Femoral Shaft Fracture with Interlocking Humeral Nail in Older Children and Adolescent

Kun-Bo Park, M.D., Hoon Park, M.D.^*, Hyun-Woo Kim, M.D.^*, Hui-Wan Park, M.D.^*, Jae Young Roh, M.D.^†

Department of Orthopaedic Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

^*Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

^†Department of Orthopaedic Surgery, Konyang University College of Medicine, Daejeon, Korea.

Address reprint requests to: Jae Young Roh, M.D. Department of Orthopaedic Surgery, Konyang University Hospital, 685, Gasuwon-dong, Seo-gu, Daejeon 302-718, Korea. Tel: 82-42-600-6903, Fax: 82-42-545-2373, jyroh@kyuh.co.kr

Received 12 October 2009 Revised 18 December 2009 Accepted 2 February 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the results of interlocking humeral nail for femur shaft fractures through the greater trochanter in older children and adolescent.

Materials and Methods

Eleven femoral shaft fractures in ten patients were selected. They were consisted of 9 boys and 1 girl. Two patients had osteogenesis imperfecta and one patient had a simple bone cyst as an underlying disease. 7 cases were right side and 4 cases were left side. The mean age at the time of operation was 12 years and 7 months (8 years 11 months~15 years 7 months). The mean follow-up period was 21 months and interlocking humeral nail was inserted at the greater trochanter in all patients.

Results

All patients had a complete bony union without any complication such as infection, nonunion, leg length discrepancy and metal failure. Avascular necrosis of femoral head and coxa valga were not developed in all patients.

Conclusion

Intramedullary nailing through the greater trochanter using interlocking humeral nail is effective and safe treatment for the femoral shaft fracture in older children and adolescents.

Keywords: Children, Adolescent, Femur shaft fracture, Interlocking humeral nail

Figures and Tables

Fig. 1

The design of unreamed humeral nail shows the bending of proximal nail end by 5° medially.

Fig. 2

An 11⁺⁹ years old boy (Patient No.3) had a shaft fracture of the femur. Preoperative anteroposterior and lateral radiographs (A) show the proximal 1/3 shaft spiral fracture. Immediate postoperative anteroposterior and lateral radiographs (B) show the internal fixation with unreamed humeral nail via the tip of the greater trochanter. Postoperative 3 months follow-up anteroposterior and lateral radiographs (C) show bony union without complications. The boy has neither subjective nor objective discomfort with full weight bearing gait. Postoperative 15 months Scanogram (D) after hardware removal show no leg length discrepancy deformity and distortion of the proximal femoral area.

Fig. 3

A 13⁺¹ years old boy (Patient No.10) had a simple bone cyst in the femur (A).

He had a pathologic fracture of the femur shaft during running (B).

Immediate postoperative anteroposterior and lateral radiographs (C) show the internal fixation with unreamed humeral nail via the tip of the greater trochanter. Postoperative 4 months follow-up anteroposterior and lateral radiographs (D) show bony union.

Table 1

Summary of cases

^*OI: Osteogenesis imperfect, ^†SEP: Static encephalopathy, ^‡SBC: Simple bone cyst, ^§TA: Traffic accident, ^∥EDH: Epidural hematoma.

Table 2

Results

^*NSA: Neck shaft angle, ^†ATD: Articulotrochanteric distance.

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