الفهرس 
Types of StudiesOnly 14 pages are availabe for public view
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Abstract
Background: Femoral shaft fractures are among the most common fractures of long bones. Paediatric diaphyseal femur fractures account for 1.4% to 1.7% of all paediatric fractures; the annual rate of children who present with femoral shaft fractures is estimated at 19 per 100,000. The management of paediatric diaphyseal femoral fractures depends primarily on the age of the child although the bone age and size of a child may determine the choice of treatment. The choice of management may also be determined by surgical experience and local trends in practice. Non- operative management plays a role in some cases still though current practice has veered towards operative fixation as it allows early mobilization and shorter hospital stays.
Aim of the Work: to evaluate efficacy and outcomes of submuscular plating and elastic stable intramedullary nailing in paediatric diaphyseal femoral fractures.
Patients and Methods: Search results will be conducted to systematic review management software and manually screened for eligibility to be included. PRISMA flowchart will be produced based on the search results and the inclusion/exclusion criteria. A total of 303 cases were included with mean age 8.3 years. The majority of them were males.
Results: The current study showed that regarding Outcome; Mean operative time was 74.35 min in nail group vs 111.19 min in plate group. Mean intraoperative blood loss also was 58.1 ml in nail group vs 112.5 ml in plate group. As regarding hospital stay mean period was 4.4 days in nail group vs 5.5 days in plate group. As regarding time to full weight bearing was 10 wk in nail group vs 8.25 wk in plate group. Time to heal of fracture was 2.28 mn in nail group vs 2.35 in plate group. Total number of union in nail group was 161 cases vs 118 in plate. Our results showed that as regards complications; a total of 60 complications were found among included cases in form of infection in 3 with nail vs 4 with plate, malunion in 14 in nail vs 6 in plate group. Heterotopic ossification in 2 cases with plate fixation. Limb length discrepancy in 6 cases with nail vs 5 cases with plate fixation, refracture in 2 cases with plate fixation, pain in 7 cases with nail fixation. External rotation and antecurvatum in 4 cases with nail fixation vs 3 with plate fixation.
Conclusion: this review provides evidence that both ESIN and SMP are safe, effective, and minimally invasive surgical methods for the treatment of paediatric diaphyseal femoral fractures, under the conditions that the surgical techniques required have been mastered and the indications for surgery are observed carefully.