NEUROLOGIC COMPLICATIONS OF PEDIATRIC FEMORAL NAILING

Neurologic complications of femoral redding with interIocking nails we re investigated in 35 consecutive pediatric patients, aged 10-17 years , with traumatic femur fractures. We examined various risk factors for neurologic complications, including timing and duration of surgery, p reoperative and intraoperative traction type, adequacy of preoperative traction, intraoperative patient position, degree of comminution of t he fracture: and use of interlocking screws. There were eight (22.2%) neurologic complications. Of these, only two (5.6%) persisted for long er than a week. The combination of surgical delay >48 h, preoperative shortening, and the use of boot traction increased the incidence of al l palsies to 5.68 times and peroneal palsies to 11.4 times that of pat ients without this combination of risk factors, Adequate pre- and intr aoperative skeletal traction, especially in patients with hours of sur gical delay, may decrease the incidence of neurologic complications in pediatric femoral nailings.