Flexible Intramedullary Nail Versus Submuscular Locked Plate with the Cluster Technique in Pediatric Femoral Shaft Fractures Fixation

Indian J Orthop. 2021 Nov 19;56(4):580-586. doi: 10.1007/s43465-021-00571-7. eCollection 2022 Apr.

Abstract

Purpose of the study: The aim of this study is the comparison between the flexible intramedullary nail and submuscular Locked Plate with the cluster technique in fixation of pediatric femoral shaft fractures at the age group between 6 and 12 years old with simple diaphyseal closed or Gustilo open grade I fractures.

Methods: Fifty children aged 6-12 years with femoral fractures were enrolled in this study. The children were randomly assigned equally to the two groups for fractures fixation. The follow-up period was 1 year. A comparison of various parameters and outcomes between both groups was documented.

Results: No significant differences were detected between both groups regarding the age, gender, affected side, mechanisms of fracture, or fracture classifications. The operative time and radiation time were longer in the plating group, while the amount of blood loss was lesser in the nail group. The patients treated with plating had better results concerning knee range of motion, weight-bearing, malalignment, and length discrepancy, with fewer complications and better functional outcomes.

Conclusion: The result of the present study supports the use of submuscular locked plate with cluster technique in the treatment of studied fractures over flexible IMN.

Keywords: Cluster technique; Flexible intramedullary nail; Pediatric femoral shaft fractures; Submuscular locked plate.