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Background: femoral shaft fracture is one of the most common fractures in children, the traditional treatment of cast immobilization, lower limb traction surgical methods such as reduction and internal fixation. Each method has advantages and disadvantages, and limited by a variety of factors, orthopedic surgeons continue to seek a more appropriate method. Closed reduction, treatment of children with femoral fractures fixed by the skin elastic intramedullary nail (Titanium Elastic Nail, TEN) is carried out in recent years, minimally invasive surgery is usually the treatment of children under five years of age or limbs, trunk-like fracture. Point support principle fracture to stretch fixed, optimized for transverse and short oblique fractures. The method as an emerging technology, whether for fracture treatment of our children, and what the advantages and disadvantages for our study. Objective: To study the elastic intramedullary nail in treatment of femoral shaft fractures in children indications, surgical techniques, clinical efficacy, complications and attention to matters, provides a practical method for the treatment of long bone fractures in children. Methods: A retrospective analysis of our department from October 2005 to August 2007 TEN treatment of children femoral shaft fractures in 78 cases, 46 cases were male and 32 females; right side of the 42 cases, 36 cases left; injured Age 1-year-old and 7 months to 13 years old, an average of 7.8 years; injury to surgery time of 50 minutes to 10 days, an average of 1.3 days. Based on age, type of fracture and the different parts of a single needle fixed 12 cases to 66 cases, double needle fixed; is using needle 51 cases of retrograde and antegrade needle 16 cases, anterograde combined retrograde needle 11 cases. Results: 78 patients were followed up for a mean follow-up of 19 months. Fracture healing assessment: excellent in 65 cases, in accordance with the criteria proposed by Flynn 2001 (limb length inequality lt; to 1.0cm, fracture angulation lt; 5 °, no pain, no complications); good in 8 cases (limb unequal length lt; 2.0cm, fracture angulation lt; 10 °, no pain, fewer complications, or can be resolved); poor in 5 cases (limb length inequality gt; to 2.0cm, fracture angulation gt; 10 °, there pain, serious complications can persist), excellent fracture healing rate was 93.6%. Poor 5 cases, 2 cases of the Department of limb shortening gt; 2cm, follow-up of 1.5 years, limb length inequality lt; 1.0cm, the other three cases is 30-50 ° knee limited functional exercises for 1 year after the two cases limited knee lt; 15 ° knee joint activity limitation gt; 30 °, excellent rate of 98.7%. The group of non-TEN fracture and nonunion cases occurred. Conclusion: The use of elastic intramedullary nail in the treatment of children with femoral shaft fracture treatment is a safe, simple, fast and long bone fractures in children, suitable for almost all children femoral shaft closed fractures, especially in the transverse and short oblique fractures . Compared with the traditional splint or cast immobilization or open reduction technology, it has a small skin wounds, tissue damage, does not damage the epiphyseal plate, does not affect the blood circulation of bone marrow within the fracture healing quicker recovery period is short hospital stay, fixtures unplug convenient, the children easily tolerated advantages, is an ideal children's femoral fractures and internal fixation method should be widely applied.
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