Intramedullary nailing versus submuscular plating in adolescent femoral fracture

Injury, 05/17/2012

Park KC et al. – Although both intramedullary nailing (IN) and submuscular plating (SP) yield good results and minimal complication in adolescent femoral fractures, IN may be advantageous in less need of fluoroscopy, technical easiness in reduction and early weight bearing.


  • The authors performed the prospective, comparison study of IN and SP in adolescent femoral shaft fractures at a mean age of 13.9years (11–17.4).
  • Twenty–two cases of IN and 23 cases of SP were followed for a minimum of 1year.
  • They compared radiological and clinical results, surgical parameters, and complications of two techniques.


  • Bony union was achieved in all cases except one case of IN.
  • Time to union was similar in both groups.
  • None showed mal–union over 10° or limb length discrepancy over 1cm.
  • None of SP group and 2 in IN group experienced re–operation; one patient had deep infection with nonunion.
  • The other patient sustained mal–rotation.
  • Both patients healed after revision procedure.
  • All patients showed excellent or satisfactory results of Flynn's criteria.
  • The time to full–weight bearing was shorter in IN (IN: 57.3days, SP: 89.2days, p<0.05).
  • In surgical parameters, operative time seemed shorter in IN (IN: 94.7min, SP: 104min, p=0.095), and fluoroscopy time was shorter in IN (IN: 58s, SP: 109s, p<0.05) than SP group.

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