OBJECTIVETo investigate curative effects of elastic stable intramedullary nails in the treatment of stable and unstable fractures of femoral shaft in children and to guide its clinical application.

METHODSFrom January 2008 to October 2010,44 children with femoral shaft fractures were treated,including 24 boys and 20 girls,ranging in age from 5 to 12 years, with an average of 7.4 years. Based on the fractures stable or not, the patients were divided into stable fractures group(group S) and unstable fractures group (group U). All the children received the same operation to fix broken femoral with elastic stable intramedullary nails and some children received traction or small splint protection after operation when reduction and fixation were considered unsatisfied or his/her weight beyond 30 kg. During the followed-up, the healing time, irritation of the soft tissue (ache, cyst, t al), malunion (angulation above 5 degree in X-ray), limb shortening or lengthening and excellent and good rate were observed.

RESULTSAll the patients were followed up,and the duration ranged from 5 to 19 months, with an average of 13 months. All the fractures were healed at the latest follow-up. The average healing time was 10.2 weeks (ranges, 8 to 14 weeks). The incidence rate of malunion was 23.8% in group U and the average angulation was 9 degree (6 to 12 degree), which was higher than those of patients in the group S (0%). The average healing time, limb shortening or lengthening, irritation of the soft tissue and the excellent and good rate between two groups had no significance differences, which were (10.6 +/- 1.3) vs. (9.9 +/- 1.2) weeks, 0 vs. 3 cases, 3 vs. 1 case and 2 vs. 4 cases respectively. In the group U, among 5 patients had malunion, 4 patients were not treated with traction or small splint protection,and the incidence was higher than those who were given traction or small splint protection.

CONCLUSIONBoth the stable and unstable femoral shaft fractures in children treated with elastic stable intramedullary nails can receive well short-term curative effects. If given certain postoperative protection like as traction or small splint, the malunion incidence can be reduced.