Locking Enders rod use yields good results in length unstable pediatric fractures

Ellis HB. J Ped Orthop. 2011. doi: 10.1097/BPO.0b013e31822ed34d

The use of locking Enders rods in length unstable pediatric fractures my help prevent shortening without increasing blood loss, surgical time or complication rates, according to the study from researchers in Texas.

The researchers performed a retrospective clinical and radiographic review of patients who underwent flexible intramedullary fixation for length unstable femoral shaft fractures — defined in the study as being either a comminuted fracture or a spiral fracture longer than twice the femoral shaft’s diameter — at one institution from 2001 to 2008.

The team found 107 length unstable femoral shaft fractures which had been repaired with Enders rods. Thirty-seven of these cases (35%) had these rods locked through the eyelet of the distal femur via cortical screw. The team recorded patient demographics, clinical protocol, complications, fracture characteristics and radiographic outcomes for each patient, comparing these factors between locked and non-locked groups.

Operative variables, demographic data, fracture location and pattern, time to union, major complications and femoral alignment were similar between the groups. Femur shortening and nail migration were measured at 1 week and 6 weeks postoperatively, with the non-locked group displaying greater changes.

“At final follow-up, there were significantly more clinical complaints in the non-locked group, including limp, clinical shortening and painful palpable rods,” the authors wrote.