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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Original Article
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.; Journal of the Korean Fracture Society 2010;23(2):206-212.
DOI: https://doi.org/10.12671/jkfs.2010.23.2.206
Published online: April 30, 2010

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: October 12, 2009 • Revised: December 18, 2009 • Accepted: February 2, 2010

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Abstract
REFERENCES

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.
Key words: Children, Adolescent, Femur shaft fracture, Interlocking humeral nail

REFERENCES

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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.

Figure & Data

REFERENCES

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

J Korean Fract Soc. 2010;23(2):206-212. Published online April 30, 2010

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

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Figure

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

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.

Fig. 1

Fig. 2

Fig. 3

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

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.

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.