Elastic fixation of the diaphyseal fractures of the femoral bone in children

The standard treatment of most fractures of the femoral bone in children was conservative. There are a variety of circumstances (polytrauma, head injury, open fracture, vascular injuries, impossibility of the satisfactory reposition by traction) that require surgical operation.

The aim of this study is the appreciation of the diaphyseal fractures' fixation using the elastic pins.

We propose the experience of the use of the elastic pins in nine patients (seven boys, two girls) aged from 7 to 12 years, with closed fractures of the femoral bones' diaphysis, who were treated by close reposition method with following elastic pins' fixation.

The causes of the trauma were the results of traffic incidents: six cases (66%), street incidents: three cases (34%), fall from a height. Six patients had a polytrauma and three had the isolated trauma. All fractures were closed, transverse or oblique-transverse. The time of stay in the hospital from admission to surgery was 1.5–15 hours.

During the first week the patients were in a bed regimen, beginning from the second week their ambulation was exercised with crutches. Hospital stays lasted from 12 to 29 days (average 15.7 bed-days). The complete load was allowable in 8 weeks after surgery. One case demonstrated a reverse prolapse of the pins in 4 months, which were removed because of the fracture's fusion. There were no other complications. All fractures knitted well during 8–10 weeks. The observation time was from 8 to 26 months.

We used the ESIP principle in the treatment of femoral fractures by two elastic pins in children aged from 7 to 12 years. This method allows one to combine stable and elastic immobilization. The stability is achieved not only by pins, but by the surrounding soft tissue. The bone forms the axial stability in the cortical contact when the pins are fixed in the metaphysis. Rotation stability is created using the incurvated pins that compose the three-point fixation. Elastic mobility allows one to have the determined motion amplitude at the fracture's site, stimulating callus formation.