Intramedullary nailing of femoral fractures in adolescents

Fifty femoral shaft fractures were treated with reamed, interlocking, intra medullary nails utilizing a greater trochanteric starting point from 1991 t hrough 1998. The 17 girls and 31 boys ranged in age from 10 to 16 years (me an, 13.2 years) at the time of injury. Average follow-up after fracture was 16 months. All fractures united, and the average leg-length discrepancy wa s 1 mm (range, -10 mm to +11 mm). No patient had angular or rotational defo rmities. No patients developed osseous necrosis of the femoral head. Despit e intramedullary nailing through the greater trochanteric apophysis, articu lotrochanteric distance measurements increased only 4.5 mm at the time of l ast follow-up. No patient developed significant proximal femoral deformity with some follow-up as far as 60 months from the time of surgery. Intramedu llary nailing through a trochanteric starting point is a safe, effective me thod for treating femur fractures in this adolescent age group.