Summary
We have reviewed 29 cases of very unstable diaphyseal fractures of the femur in children and adolescents treated by Kuntscher nailing. Follow up was for at least 5 years, and in most cases until after the end of growth. There were no post-operative complications, and the mean overgrowth of the femur was 7.06 mm. There was growth disturbance of the proximal femur in one case, but this did not interfere with function. We believe that Kuntscher nailing is indicated in children and adolescents with unstable high velocity fractures of the femoral shaft.
Résumé
Le traitement chirurgical des fractures de la diaphyse fémorale de l'enfant et de l'adolescent ne se justifie que dans des situations extrêmes. Le degré d'instabilité de la fracture doit être pris en considération. Nous avons revu 29 fractures très instables de la diaphyse fémorale, chez des enfants ou des adolescents, traitées par enclouage selon Kuntscher, pendant une période de 7 ans, avec un recul minimum de 5 ans et pour la plupart jusqu'à la fin de la croissance. Il n'y a pas eu de complication post-opératoire. On a observé un hyper-allongement du fémur de 7.06 mm en moyenne. Dans un seul cas il est apparu des troubles de croissance de l'extrémité supérieure du fémur, compatibles avec une fonction normale. Nous pensons que dans les fractures très instables de l'enfant et de l'adolescent, produites par des traumatismes très violents, l'enclouage d'alignement a des avantages et permet d'obtenir des résultats très satisfaisants.
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Maruenda-Paulino, J.I., Sanchis-Alfonso, V., Gomar-Sancho, F. et al. Kuntscher nailing of femoral shaft fractures in children and adolescents. International Orthopaedics 17, 158–161 (1993). https://doi.org/10.1007/BF00186377
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DOI: https://doi.org/10.1007/BF00186377