Elastic nail versus plate for treatment of single close fracture of femur shaft

This study aims to describe the outcome of pediatric flexible nails versus plates for the treatment of femur fracture. We reviewed the medical records of 28 femur fractures in children treated with flexible nail insertion and 26 children treated with plate fixation from January 2017 to December 2019. The mean age of the children was 8.88 ± 1.86 years. Data were obtained from patient charts. Union of bones was found in all the operated children, 28 (51.9%) of the group flexible nails, while no union was found in 3 (5.6%) of the group plate with screws. Delay union was found in 5 (9.3%) of the plate with screws, while in the group of flexible nails was in 2 (3.7%). Malrotation was found in 2 (3.7%) of the flexible nails and in 1 (1.9%) in the plate and screw. Bursa was found only in the flexible nails with 7 (13%) (p = 0.007). Re-fracture was found only in the group of plates with screws with 5 (9.3%) (p = 0.021). The limbs were shortened only in 1 (1.9%) patient with flexible nails. Superficial infection was high in the group plate with screws group 4 (7.4%). Deep infection was found to be high among 3 (5.6%) of the group plate & screw. We conclude that flexible intramedullary nail fixation of fracture shaft femur in children is a very acceptable way of treatment and is associated with minimal complications.