Background: Pediatric femoral shaft fractures are one of the common fractures that we encounter in the orthopedics outpatient department. These fractures have various treatment options ranging from traction and early hip spica casting to elastic titanium intramedullary nails [titanium elastic nailing system (TENS)] and reamed intramedullary nails. In this study, we are evaluating the functional outcome and results following the use of flexible intramedullary nails and conservative management for femoral shaft fractures in children. Methods: This was a prospective observational study which was carried out in a tertiary care hospital from October 2015 to May 2017 for two groups of children who sustained traumatic femoral shaft fractures. A total of 40 patients were taken into consideration with 20 patients each in two groups. Results: The male-to-female ratio was 2. 6: 1 in our study population. The overall post-operative complication rate was more in the TENS group. Besides, we found that the TENS group of patients had a less limb length discrepancy (LLD) (P = 0. 004) and a lower degree of angular deformity (P = 0. 36). Conclusion: TENS demonstrated advantages including sufficient axial stability, early mobilization, and more rapid return to function than spica cast treatment, however, it had the drawback of possible infection and pin site irritation. Overall, TENS offers a minimally invasive method for treatment of the femoral shaft fractures in children which stands superior to traditio nal spica casting.

Background: Femoral shaft fractures regularly occur after major trauma, such as road traffic accidents and falls from a height (1, 2). These fractures usually are associated with concurrent injuries due to the high-energy forces in the trauma (3). In addition, due to osteopenia, this type of fracture is also frequent in the elderly population (1, 4). The AO Foundation/Orthopedic Trauma Association (AO/OTA) has categorized femoral shaft fractures into three subtypes: A, B, and C,they represent the simple fracture, fractures with more than two fragments (with maintained continuity), and complicated with disjoined bone cortex subsequently (5). . .

Background: Femoral nonunion is an important complication, which can occur after intramedullary nailing and it requires surgical intervention. Plate augmentation over intramedullary nail is emerging as an acceptable option with satisfactory results for femoral nonunion. Objectives: The aim of the present study was to determine whether plate augmentation over retained intramedullary nail is an effective treatment for nonunion of femoral shaft fracture. Methods: Overall, 35 cases of femoral nonunion, initially treated with intramedullary nailing, were managed with plating augmentation. Patients with oligotrophic or atrophic nonunion also received iliac cancellous auto graft. The outcome was evaluated by the rate and duration of union and complications were recorded. Results: All patients achieved bony union during an average time of 21 weeks ( 3. 94) and no union occurred later than 35 weeks. In plain radiography, evidence of callus formationwasseen atmeantime of 10 weeks. Therewasnostatistically significant difference in union time among different types of nonunion (P: 0. 466) while a significant difference was noticed in the time for callus formation (P < 001). Also, no complications were observed. Conclusions: Plating augmentation is an effective and safe treatment option for nonunion of femoral shaft fractures.

Objective: This case report aims to demonstrate an instance of superficial femoral artery (SFA) rupture after an open femoral shaft fracture. Case Presentation: Our patient was a 22-year-old man admitted to the emergency department after a motorbike accident with a deformity at the distal third of the thigh and an open wound on the medial side. Radiographs and computed tomography angiography revealed a left distal third femoral fracture with ipsilateral SFA injury. We performed fracture reduction external fixation following SFA reconstruction using a 5-cm saphenous vein autograft. Prophylaxis fasciotomy was not performed. At a 6-month follow-up, the wound was well-healed, the Doppler ultrasound showed good blood flow at the reconstructed artery, and a rigid callus entirely covered the fracture. At 1-year follow-up, the patient could walk with full weight-bearing. Maximum knee range of motion was restored, and the patient could return to daily activities. Conclusion: Vascular injury after femoral shaft fracture is rare, and accurate diagnosis with timely and appropriate surgery plays a crucial role in achieving limb salvage, reducing the risk of complications, and improving the overall quality of patient life.