Outcomes of Intramedullary Nail Without Locking in Patients Aged 10-16 Years Having Closed Femoral Shaft Fracture
DOI:
https://doi.org/10.54112/bcsrj.v6i12.2110Keywords:
Femoral shaft fracture, Adolescent, Intramedullary nailing, Non-locking nail, Functional outcome, Paediatric orthopaedicsAbstract
Femoral shaft fractures in school-aged children and adolescents pose therapeutic challenges due to growth considerations and the need for early mobilization. Flexible intramedullary nailing without locking has emerged as a minimally invasive option with favorable outcomes. Objective: To assess the functional outcomes of intramedullary nail without locking in patients aged 10-16 years having closed femoral shaft fractures. Methodology: This study was conducted on a cohort of 70 patients aged 10 to 16 years presenting with closed femoral shaft fractures from August 2024 to August 2025 at the Department of Orthopedic Surgery, Hayatabad Medical Complex, Peshawar. All patients underwent closed reduction and internal fixation with a flexible intramedullary nail system without interlocking screws. Functional outcome was assessed at three-month follow-up using Flynn's TEN criteria, which categorise outcomes as excellent, good, and fair. SPSS 25 was used for analysis. Results: The mean age of 70 patients was 12.74 years. The majority of the patients were male, 64.3%. Functional outcomes were excellent in 46 cases (65.7%), good in 19 cases (27.1%), and fair in 5 cases (7.1%). Postoperative complications were skin irritation (4.3%) and limb length discrepancy (2.9%). A statistically significant association was found between functional outcome and complication status. Conclusion: Non-locking intramedullary nailing is an effective and safe surgical procedure for closed femoral shaft fractures in children aged 10–16 years. The procedure exhibited a high rate of excellent functional outcomes and a lower incidence of complications.
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References
Sigrist EJ, George NE, Koder AM, Gwam CU, Etcheson JI, Herman MJ. Treatment of closed femoral shaft fractures in children aged 6 to 10 years. J Pediatr Orthop. 2019;39(5):e355–e359. https://doi.org/10.1097/BPO.0000000000001335
Korytkowski PD, Panzone JM, Aldahamsheh O, Alkhayarin MM, Almohamad HO, Alhammoud A. Open and closed reduction methods for intramedullary nailing of femoral shaft fractures: a systematic review and meta-analysis of comparative studies. J Clin Orthop Trauma. 2023;44:102256. https://doi.org/10.1016/j.jcot.2023.102256
Flynn JM, Schwend RM. Management of pediatric femoral shaft fractures. J Am Acad Orthop Surg. 2004;12(5):347–359. https://doi.org/10.5435/00124635-200409000-00008
Murphy JS, Koehler R, Johnson M, Hosseinzadeh P. Flexible intramedullary nailing of pediatric femoral fractures. JBJS Essent Surg Tech. 2021;11(1):e19.00064. https://doi.org/10.2106/JBJS.ST.19.00064
Abdul Wahid AHMA, Tarafder MWH, Haque E, Rahman SMT, Tahrima N-e. Functional outcome of femoral shaft fracture in pediatric patients treated by the titanium elastic nailing system. Int J Res Orthop. 2024;10(5):940–944. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20242386
Parekh MN, Sahito B, Kumar S. Treatment of paediatric femoral shaft fracture with flexible intramedullary nail. J Surg Pak. 2020;25(1):13–17. https://doi.org/10.21699/jsp.25.1.4
Hashmi MU, Ahsan MN, Chughtai BB. Early outcomes of flexible intramedullary nailing in pediatric shaft of femur fractures. Pak Armed Forces Med J. 2021;71(6):2157–2160. https://doi.org/10.51253/pafmj.v71i6.6137
Ali R, Ali M, Altaf W, Saleem F, Ali S, Ullah I. Functional outcomes of flexible intramedullary nails in the management of femoral diaphyseal fracture in children. Pak J Health Sci. 2025;6(11):82–86. https://doi.org/10.54393/pjhs.v6i11.3450
Koroglu M, Karakaplan M, Ergen E, Gunduz E, Ozdes HU, Aslanturk O. Functional outcomes of titanium elastic nail procedure after femoral shaft fracture in pediatric patients. Med Sci. 2023;12(3):746–752. https://doi.org/10.5455/medscience.2023.05.073
Shams MA, Mondal S, Hossain GMJ. Short-term clinical, functional, and radiological outcome of fixation of paediatric femoral shaft fracture by titanium elastic nail. EAS J Orthop Physiother. 2022;4(4):20–25. https://doi.org/10.36349/easjop.2022.v04i04.001
Uddin MM, Islam T, Hossain MS, Rashid MHA, Bose B, Rana MS. Outcome of closed intramedullary fixation of femoral shaft fracture by titanium elastic nail in children. Int J Res Orthop. 2025;11(2):264–268. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20250448
Abbas MM, Sadiq BS, Habib U, Usman MA, Ayoub S, Waseem Q, et al. To evaluate the outcome of intramedullary nailing in femoral shaft fractures in children. Prof Med J. 2024;31(12):1738–1741. https://doi.org/10.29309/TPMJ/2024.31.12.8334
Huang J, Bian Y. Comparative analysis of adolescent intramedullary nailing and locking plate fixation for femoral shaft fractures. Front Surg. 2025;12:1614146. https://doi.org/10.3389/fsurg.2025.1614146
Kapil Mani KC, Dirgha Raj RC, Parimal A. Pediatric femoral shaft fractures treated by flexible intramedullary nailing. Chin J Traumatol. 2015;18(5):284–287. https://doi.org/10.1016/j.cjtee.2015.05.002
Rehm A, Butt J, Shehata R, Hatzantoni K, Judkins N. Plate fixation versus flexible intramedullary nails for management of closed femoral shaft fractures in the pediatric population: a systematic review and meta-analysis of adverse outcomes. J Child Orthop. 2024;18(5):546–547. https://doi.org/10.1177/18632521241264129
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Copyright (c) 2025 Fazal Amin, Muhammad Dayan Khan, Tahir Hassan, Muhammad Saeed Ahmad, Muhammad Ihtisham Khattak, Abrar Ul Haq

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