Background: Although flexible intramedullary nailing is a popular treatment option for femoral shaft fractures in juvenile and young adolescent patients, it may not be appropriate in some patients because of patient size and/or fracture configuration.
Methods: Retrospective review over a 3-year period identified 17 skeletally immature patients (18 fractures) with femoral shaft fractures treated with noncannulated rigid locked intramedullary nailing because of a length-unstable fracture or patient overweight or obesity. The 14 males and 3 females had an average age of 10 years at the time of injury (range, 7.6 to 11.9 y). Their average weight was 38.3 kg (range, 22.7 to 52 kg), with an average body mass index of 18.9 (range, 13.9 to 26.9).
Results: All fractures united at an average of 13 weeks, with no osteonecrosis, malalignment, malunion, or hardware failure.
Conclusions: Preliminary results suggest that noncannulated, rigid, locked intramedullary nails can be used safely and effectively for selective fixation of femoral shaft fractures in skeletally immature patients younger than 12 years of age.
Level of Evidence: Level IV.