INTRAMEDULLARY NAILING OF THE FEMUR IN CHILDREN

We have studied the medium- and long-term effects of femoral intramedu llary nailing in 34 children, There was a high incidence of abnormalit y at the proximal end of the femur, including cosa valga, arrest of gr owth of the greater trochanter and thinning of the neck of the femur, because of damage to the trochanterocervical growth plate. These disor ders affected 30% of the patients, mostly under the age of 13 gears (p < 0.05), and were seen more frequently when the nail had been introdu ced through the piriform fossa, Other factors, such as the side, gende r, aetiology, proximal or retrograde insertion, the size of nail and r emoval of the implant did not influence the result. We recommend that in patients under the age of 13 years other methods of management shou ld be used to avoid damage to the growth plate.