Locking plate construct for femoral shaft fractures in skeletally immature patients.

Different methods of internal fixation are used in the treatment of femoral shaft fractures. Results of locked plate fixation in adults have been encouraging. A locking plate construct with a standard broad Dynamic Compression Plate (DCP) and 4.5 mm nuts was used in the treatment of femoral shaft fractures in 15 skeletally immature patients. There were 12 boys and three girls. The mean age was 9.4 years at time of injury. Three fractures were open. All fracture healed in an average time of 8 weeks. The follow-up period ranged from 6 to 30 months (mean 18 months). Screw failure in form of bending or breakage occurred in two patients, without clinical consequences. Fatigue fracture of the two screws in the proximal fragment occurred 15 weeks after fixation in another patient, which eventually healed with a 15 degrees varus angulation. There was an average femoral lengthening of 2.3 mm in six patients and 2 mm of tibial lengthening in four patients. All patients returned to their pre fracture level of activity. The locking plate construct used in this study appeared as a reliable method for the treatment of femoral shaft fractures in skeletally immature patients.