The safety of titanium elastic nailing in preschool femur fractures: a retrospective comparative study with spica cast.

One hundred and four nonpathological fresh femur fractures not involving the neck or condyles in two groups of preschool children were retrospectively compared and followed up for a minimum of 3 years. Group I was treated by a spica cast and group II was treated by a titanium elastic nail (TEN). The mean age of the children was 4.5 years. TEN was statistically better in terms of union (P=0.000), shortening (P=0.016), sagittal angulation (P=0.018), coronal angulation (P=0.022), rotation (P=0.014), earlier weight bearing (P=0.000), and earlier return to nursery (P=0.000). However, both groups had a similar overgrowth rate and hospital stay time. TEN in preschool children is a safe choice but involves a scar, risk of infection, and the need for a second operation.